Credentialing Specialist

2 days ago

Mandaluyong City, National Capital Region, Philippines ISTA Solutions, Inc. Full time $4,000 - $6,000 per year

ISTA Solutions, an outsourcing/offshoring company, is in search of an experienced Healthcare Customer Service Representative to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals, who prioritize employee satisfaction and work-life balance. At ISTA Solutions, we pride ourselves on creating a culture focused on long-term success and life-long learning. We're looking for a team player who is ready to contribute to our mission, just like you

Account specific roles and responsibilities

  • Coordinate and manage the credentialing process for healthcare providers and facilities with payers, health plans, and other organizations.
  • Ensure timely submission, tracking, and follow-up of all credentialing applications and re-credentialing efforts.
  • Maintain accurate and complete provider records in internal databases and payer portals.
  • Interpret and apply payer requirements and federal/state regulations to ensure compliance.
  • Liaise with providers, internal teams, and external payer contacts to resolve credentialing issues and ensure smooth onboarding.
  • Monitor expiration dates for licenses, certifications, and insurance, and initiate timely renewals.
  • Assist in the execution and maintenance of provider contracts and agreements.
Requirements
  • At least 6 months BPO experience in a Healthcare Account, specifically handled Credentialing
  • Good working knowledge with US Healthcare Insurance (Medicare, Medicaid, etc)
  • Familiar with MS Tools (Word, Excel, Outlook)
  • Excellent verbal and written English skills
  • Must be willing to work on-site in Mandaluyong
  • Amenable working night shifts
Benefits

What can we offer you?

  • Competitive salary and benefits
  • Health Insurance with free dependents*
  • 10%-night differential
  • Attendance Bonus
  • Paid time off
  • Convertible to cash leave credits
  • Performance Appraisal
  • Work-life balance
  • A focus on growing your career path with us
  • We encourage you to follow your passions and learn new skills

Our commitment to you

  • Strong culture and values-driven leadership
  • We create opportunities for you to learn and grow at any stage of your career
  • Continuous learning and innovation
  • We foster an all inclusive environment where everyone thrives

  • Senior Credentialing Specialist

    2 days ago

    Makati City, National Capital Region, Philippines MCVO Talent Outsourcing Services Full time $40,000 - $80,000 per year

    Job Description:Purpose - Credentialing Specialist supports the accurate and timely credentialing and recredentialingof healthcare providers with insurance networks, clearinghouses, and other credentialing bodies. This role involvesassisting the Senior Credentialing Specialist in maintaining compliance, ensuring accurate documentation, andcoordinating with...

  • Medical Provider Licensing and Credentialing Specialist

    2 days ago

    Quezon City, National Capital Region, Philippines MicroSourcing Full time $60,000 - $80,000 per year

    Position: Medical Provider Licensing and Credentialing Specialist (Intermediate)Work setup & shift: Hybrid and DayshiftSite: 1880 Building, Eastwood, Libis, Quezon CityWhy join MicroSourcing?You'll HaveCompetitive Rewards: Enjoy above-market compensation, healthcare coverage on day one, plus one or more dependents, paid time-off with cash conversion, group...

  • Expertise in Healthcare Compliance and Credentialing

    5 days ago

    Makati City, National Capital Region, Philippines beBeeCredentialing Full time ₱800,000 - ₱1,200,000

    Healthcare Compliance and Credentialing SpecialistAbout the RoleEnsure accurate and timely compliance of contingent workers throughout their engagement with our organization.Verify healthcare providers' educational background, training, licensure, and certifications to guarantee they meet the required standards.Manage records of healthcare providers'...

  • Production Support Specialist

    4 days ago

    Mandaluyong City, National Capital Region, Philippines beBeeCorporate Full time ₱800,000 - ₱1,200,000

    Job Title: Corporate Production Support SpecialistJob Description:We are seeking a highly skilled and experienced Corporate Production Support Specialist to join our team. The successful candidate will be responsible for monitoring and maintaining the efficiency of our products and services.Provide end-to-end production support to ensure effective...

  • Team Lead for Voice Support

    3 weeks ago

    Mandaluyong City, National Capital Region, Philippines ISTA Personnel Solutions Full time

    ISTA Solutions, an outsourcing/offshoring company, is seeking an experienced Customer Service Representative to join our rapidly expanding team. As part of our team, you will work with highly skilled professionals who prioritize employee satisfaction and work-life balance. At ISTA Solutions, we focus on long-term success and lifelong learning. We are looking...

  • Team Leader

    2 days ago

    Mandaluyong City, National Capital Region, Philippines ISTA Personnel Solutions Full time $40,000 - $60,000 per year

    ISTA Solutions, an outsourcing/offshoring company, is in search of an experienced Team Lead to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals, who prioritize employee satisfaction and work-life balance. At ISTA Solutions, we pride ourselves on creating a culture focused on...

  • Medical Billing Specialist

    2 days ago

    Quezon City, National Capital Region, Philippines Sourcefit Full time $40,000 - $60,000 per year

    Position Summary:We are actively seeking an experienced and motivated Medical Billing Specialist to join our team. The successful candidate will play a crucial role in managing the billing process from claim submission to collection. The tasks include verification of benefits, clean claim submission, denial management, claim appeals, and resolving...

  • Healthcare Licensing Coordinator

    2 days ago

    Quezon City, National Capital Region, Philippines beBeeCredentialing Full time $30,000 - $45,000

    Medical Licensing SpecialistThe Medical Provider Licensing and Credentialing team is looking for a highly organized and detail-oriented individual to assist with the licensing process of healthcare providers across multiple states.Assist healthcare providers in obtaining and maintaining medical licenses by preparing and submitting applications, including all...

  • Team Lead for Voice Support

    2 days ago

    Mandaluyong City, National Capital Region, Philippines ISTA Personnel Solutions Full time $4,000 - $6,000 per year

    ISTA Solutions, an outsourcing/offshoring company, is in search of an experienced Customer Service Representative to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals, who prioritize employee satisfaction and work-life balance. At ISTA Solutions, we pride ourselves on creating a...

  • Clinical Appeals Specialist

    2 days ago

    Quezon City, National Capital Region, Philippines Pinnacle Intelligence Full time ₱50,000 per year

    We are seeking highly qualified professionals to join our team as Clinical Appeals Specialists (PHRNs). This role offers competitive compensation, bonuses, and the opportunity to work onsite in Quezon City.Role SummaryWe are looking to hire 10 Clinical Appeals Specialists (PHRNs) with an onboarding date of September 2, 2025. Candidates must complete all...