Certified Healthcare Credentialing Professional

7 days ago

Tanauan, Calabarzon, Philippines beBeeCredentialing Full time $7,200 - $7,800
Credentialing Specialist Role

We are seeking a detail-oriented and experienced credentialing professional to manage the credentialing and re-credentialing processes for clinicians and facilities.



Key Responsibilities:
  • Complete and maintain credentialing and re-credentialing applications for licensed professionals, including Behavioral Analysts and other health care providers.
  • Submit applications to commercial and Medicaid payers, including electronic networks and individual payer portals.
  • Track credentialing statuses, follow up on delays, and maintain regular communication with insurance companies to ensure timely processing.
  • Maintain accurate records of licensure, certifications, background checks, liability insurance, and other compliance documentation to support seamless clinical operations.
  • Coordinate start dates with scheduling teams to ensure active clinicians before seeing clients, ensuring smooth workflow.
  • Ensure accuracy and timely submission of demographic updates, reassignment of benefits, and provider termination notices to maintain compliance and prevent unnecessary disruptions.
  • Monitor credentialing expiration dates and initiate renewals in advance to avoid any potential lapses or issues.
  • Assist billing teams with credentialing-related claim denials and payer issues to minimize financial impacts.
  • Stay updated with payer policy changes and credentialing guidelines to adapt and optimize our clinical services accordingly.


Why This Role Matters:

This Credentialing Specialist role is crucial in maintaining the credibility and trustworthiness of our organization. By efficiently managing credentialing processes, you will contribute to delivering high-quality patient care while minimizing risks and costs associated with non-compliance.



What We Offer:

In return for your expertise, we offer a competitive compensation package, opportunities for professional growth, and a dynamic work environment that values collaboration and innovation.

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