Senior Credentialing Specialist
1 week ago
Job Description:
Purpose - The Junior to Mid Credentialing Specialist supports the accurate and timely credentialing and recredentialing of healthcare providers with insurance networks, clearinghouses, and other credentialing bodies. This role involves assisting the Senior Credentialing Specialist in maintaining compliance, ensuring accurate documentation, and coordinating with insurance networks and other credentialing entities.
Key Responsibilities
Credentialing and Recredentialing Support:
Assist the Senior Credentialing Specialist in preparing, submitting, and tracking provider enrollment applications for insurance networks and credentialing organizations.
Ensure the accuracy and completeness of provider credentialing documentation, including licenses, certifications, and insurance coverage.
Monitor and update credentialing timelines, ensuring compliance with deadlines and payer requirements.
Compliance and Documentation:
Perform primary source verifications as directed, maintaining adherence to regulatory and organizational standards.
Maintain organized credentialing records and ensure accurate data entry in credentialing software or databases.
Assist in audits of credentialing files to verify compliance with HIPAA and other regulatory requirements.
Communication and Coordination:
Act as a liaison between the Senior Credentialing Specialist, healthcare providers, and external entities to resolve credentialing-related issues.
Follow up with providers, payers, and clearinghouses to gather required information or clarify discrepancies.
Communicate updates on credentialing processes and progress to the Senior Credentialing Specialist and management.
Administrative Support:
Provide support during high-volume credentialing periods, including managing overflow tasks as assigned by the Senior Credentialing Specialist.
Prepare reports and summaries of credentialing activities for review by the Credentialing Manager or team.
Assist in training new team members on credentialing processes and software.
Required Knowledge and Skills:
Basic knowledge of credentialing processes and healthcare regulations.
Strong organizational skills with exceptional attention to detail and accuracy.
Proficiency in credentialing software and Microsoft Office Suite (Word, Excel, Outlook).
Excellent verbal and written communication skills for interacting with internal and external departments.
Ability to multitask and work collaboratively in a fast-paced environment.
Additional Requirements
Education: College or equivalent required; an Associate's degree in healthcare administration or a related field is preferred.
Experience:At least 1-3 years of administrative experience, preferably in healthcare or credentialing.
Familiarity with credentialing software and US payer processes is an advantage.
Attributes: Proactive, team-oriented, and capable of handling sensitive information professionally.
Work Environment
Office-based or remote, depending on organizational needs.
May require flexibility during high-demand periods to meet deadlines.
Shift / Hours:
Monday Friday in one single shift, 9:00 AM EST - 6:00 PM EST. Note this is +12 or +13 Philippine time, which will be 9:00 PM PHT 6:00 AM in PHT.
-
Credentialing Specialist
1 week ago
Makati City, National Capital Region, Philippines MCVO Talent Outsourcing Services Full time ₱1,500,000 - ₱2,500,000 per yearPurpose - The Junior to Mid Credentialing Specialist supports the accurate and timely credentialing and recredentialing of healthcare providers with insurance networks, clearinghouses, and other credentialing bodies. This role involves assisting the Senior Credentialing Specialist in maintaining compliance, ensuring accurate documentation, and coordinating...
-
Credentialing Specialist
2 weeks ago
Makati City, National Capital Region, Philippines PSG Global Solutions Full time ₱250,000 - ₱400,000 per yearAre you looking for a new and rewarding challenge?We're hiring aCredentialing Specialistto join our growing team This role is perfect for someone with a strong eye for detail, excellent communication skills, and hands-on experience handling credentialing documents. If you enjoy supporting recruitment operations, coordinating with multiple stakeholders, and...
-
Credentialing Specialist
2 weeks ago
Makati City, National Capital Region, Philippines PSG Global Solutions Full time ₱21,600 - ₱864,000 per yearJob Description: We're hiring a Credentialing Specialist to join our growing team This role is ideal for someone with a keen eye for detail, excellent communication skills, and hands-on experience in handling credentialing documents. If you enjoy supporting recruitment operations, coordinating with multiple stakeholders, and ensuring accuracy in every step...
-
Healthcare Credentialing Specialist
1 day ago
Makati City, National Capital Region, Philippines Penbrothers Full timeAbout PenbrothersPenbrothers is an HR & remote talent management partner and one of the fastest growing companies in the Philippines. We provide talented Filipinos with global opportunities in high-growth startups and dynamic companies, from the comfort of their own homes.About the ClientOur client is a multi-state ambulatory surgery center specializing in...
-
US Facility Credentialing Specialist
1 day ago
Makati City, National Capital Region, Philippines PENBROTHERS Full timeAbout PenbrothersPenbrothers is an HR and remote talent management partner and one of the fastest-growing companies in the Philippines. We connect talented Filipinos to global opportunities with high-growth startups and dynamic companies, enabling them to build careers from the comfort of their own homes. We provide end-to-end support in recruitment, HR,...
-
Makati City, National Capital Region, Philippines Neolytix Full time ₱3,000,000 - ₱4,500,000 per yearJob DescriptionThe Credentialing and Insurance contracting Specialist is responsible for maintaining active status for providers and groups with Insurance plans by successfully completing initial and subsequent credentialing and contracting applications as required by commercial payers, Medicare and Medicaid in different states of USA. Job...
-
US Healthcare Credentialing Specialist
2 weeks ago
Makati City, National Capital Region, Philippines PENBROTHERS Full time ₱900,000 - ₱1,200,000 per yearAbout PenbrothersPenbrothers is an HR & remote talent management partner and one of the fastest growing companies in the Philippines. We provide talented Filipinos with global opportunities in high-growth startups and dynamic companies, from the comfort of their own homes.About the ClientOur client is a multi-state ambulatory surgery center specializing in...
-
US Healthcare Credentialing Specialist
2 weeks ago
Mandaluyong City, National Capital Region, Philippines Penbrothers Live Full time ₱1,750,000 - ₱2,450,000 per yearAbout PenbrothersPenbrothers is an HR & remote talent management partner and one of the fastest growing companies in the Philippines. We provide talented Filipinos with global opportunities in high-growth startups and dynamic companies, from the comfort of their own homes.About the ClientOur client is a multi-state ambulatory surgery center specializing in...
-
Quezon City, National Capital Region, Philippines Sourcefit Full timePosition Summary:We are seeking a highly skilled and adaptable professional to join our team in a hybrid role that combines Credentialing and Medical Billing responsibilities. This position will primarily focus on credentialing tasks across various clients but will also support medical billing projects as they arise. The ideal candidate has multiple years of...
-
Credentialing Specialist
3 days ago
Mandaluyong City, National Capital Region, Philippines Vector Outsourcing Solutions Phils. Full timeJob Description:Enroll our clients who are US based health care providers, diagnostic laboratories and medical facilities as preferred providers in health care networks.Gather required enrollment documents from new clients.Assist in completing enrollment forms.Maintain accurate and current client information using spreadsheets and/or online databases.Respond...
