Healthcare Credentialing Specialist

2 days ago

Cagayan de Oro, Northern Mindanao, Philippines beBeeCredentialing Full time ₱8,800 - ₱9,700
Healthcare Credentialing Expert

We are seeking a meticulous Healthcare Credentialing Expert to manage the credentialing and recredentialing processes for healthcare providers.

  • Ensure provider files comply with state regulations, insurance guidelines, and national accreditation standards.
  • Complete and submit credentialing applications and enrollment forms to commercial payers, Medicaid, and Medicare.
  • Maintain and update provider data in credentialing systems such as CAQH, NPPES, and internal databases.
  • Track and monitor expirable items such as licenses, certifications, and recredentialing deadlines.
  • Communicate professionally with insurance companies, government agencies, and internal departments to resolve credentialing-related issues.
Required Skills and Qualifications
  • Prior experience in healthcare credentialing or provider enrollment, preferably with Maryland-based providers.
  • Familiarity with Maryland-specific credentialing standards, including Medicaid and regional payers.
  • Proficiency with credentialing platforms such as CAQH, PECOS, and NPPES.
  • Familiarity with the EPREP Portal, including provider registration and compliance functions.
  • Exceptional attention to detail and ability to manage multiple deadlines effectively.
  • Strong written and verbal communication skills; professional in interactions with both internal and external stakeholders.
Benefits

The ideal candidate will be self-motivated and reliable in a fully remote work environment.

Work Environment

Full-time position available in Cagayan de Oro, PH.

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