Insurance Credentialing Specialist – Home Health Care

If you have a insurance credentialing experience and you are ready to be part of our growing team as a Insurance Credentialing Specialist, Palmeira Lando OPC is looking for you

Why Palmeira Lando OPC?

At Palmeira Lando OPC, we're not just another BPO, we are a healthcare-first company built by professionals from the U.S. healthcare industry. We operate our own dedicated Home Healthcare facility in the U.S., giving our team direct insight into the care and quality we help deliver.

By joining us, you'll be part of a fast-growing, mission-driven team that values initiative, innovation, and integrity. We believe in empowering our employees, recognizing contributions, and creating opportunities for career advancement.

Here's what you can expect as a full-time team member:

• Competitive compensation based on your experience and performance
• HMO coverage starting on your 3rd month
• Paid time off upon regularization
• Pay raise based on performance.
• Free meals and unlimited coffee
• Structured onboarding and training (1-3 months)
• Exciting company events—locally and internationally
• Government-mandated benefits, 13th-month pay, and more

Submit your application now and a recruiter will reach out to you WITHIN 24 BUSINESS HOURS or call/text us to connect with our recruiter to do your initial interview (Available Monday - Friday, 9:00 AM to 5:00 PM)

Job Summary:

The Insurance Credentialing Specialist will support a U.S.-based home health care provider by managing all aspects of insurance credentialing, re-credentialing, and payer enrollment to keep the agency accredited and in-network with Medicare, Medicaid, and commercial insurers. This role ensures the agency's billing privileges remain active, enabling them to provide patient care and receive timely reimbursement.

As a Insurance Credentialing Specialist you will be responsible for the following:

Insurance Credentialing & Enrollment

• Prepare, complete, and submit credentialing and re-credentialing applications for the agency to Medicare, Medicaid, and commercial insurance payers.
• Manage updates to the agency's information with insurance payers (e.g., address changes, service area updates, ownership changes).
• Ensure all submissions are accurate, complete, and meet payer requirements.

Verification & Compliance

• Verify and maintain up-to-date documentation required for payer contracts (licenses, permits, certifications).
• Ensure compliance with CMS regulations, payer-specific requirements, and home health accreditation standards.
• Track re-credentialing schedules to prevent lapses in network status.

Database & Record Management

• Maintain and update agency profiles in CAQH ProView, PECOS, and payer-specific portals.
• Keep detailed logs of credentialing activities, statuses, and contract renewals.
• Prepare reports for management and compliance teams.

Communication & Coordination

• Serve as the point of contact with insurance payer representatives for credentialing-related matters.
• Follow up on pending applications and respond promptly to payer requests for additional documentation.
• Alert management to potential delays or compliance risks.

Requirements:

• At least 6 months of experience in insurance credentialing or provider enrollment, ideally in a home health or similar healthcare setting.
• Strong knowledge of Medicare, Medicaid, and commercial insurance credentialing processes.
• High attention to detail and accuracy.
• Excellent English communication skills, written and verbal.
• Strong organizational skills with the ability to manage multiple deadlines.
• Proficiency with Microsoft Office Suite and credentialing systems (e.g., CAQH, PECOS).

Preferred Qualifications

• Prior experience with U.S.-based home health agencies.
• Familiarity with accreditation requirements for home health providers.

Job Types: Full-time, Permanent

Pay: From Php25,000.00 per month

Application Question(s):

• What is the best phone number & email address to reach you?
• What is your expected salary?
• This is a FULL ON-SITE position. Our office is located at Upper McKinley, Taguig. Are you amenable to work on-site?

Work Location: In person