Credentialing Specialist

4 days ago

Taguig, National Capital Region, Philippines Intro Recruitment Asia Full time


Location:
BGC, Taguig City


Shift:
US Shift


Setup:
Full Onsite for training (approx. 3 months) then Hybrid (3x a week onsite)


Employment Type:
Full-time | Permanent | Direct Hire

The
Provider Credentialing Specialist
plays a key role in ensuring the accuracy, compliance, and efficiency of provider credentialing and re-credentialing processes. This role supports the onboarding and offboarding of healthcare providers, manages data verification, and helps maintain adherence to regulatory and organizational standards.

We're looking for someone with great attention to detail, strong organizational skills, and a passion for supporting quality healthcare operations.


What You'll Do:

  • Process timely and accurate initial credentialing and re-credentialing of affiliated network practitioners.
  • Conduct primary source verification (PSV) and manage supporting documentation.
  • Support compliance audits of delegated healthcare entities and prepare reports with findings and recommendations.
  • Monitor expiring credentials and perform timely re-verifications to maintain compliance.
  • Collaborate with leadership to review and improve department policies and procedures.
  • Update and maintain provider demographic information while ensuring data accuracy and confidentiality.
  • Provide excellent service and communication throughout the credentialing process.


What You Bring:

  • Bachelor's Degree in Business, Healthcare, or a related field (preferred)
  • At least 1 year of experience in medical staff services or a CVO setting (preferred)
  • Familiarity with regulatory and accreditation standards (e.g., NCQA, Joint Commission)
  • Strong attention to detail, organization, and communication skills
  • Experience with HR background checks and employment verification in the medical field (a plus)
  • CPCS or CPMSM certification (preferred but not required)


Why join us?

  • A global company with a rich 150-year history, now with a new presence in the Philippines.
  • Health & Protection:
    HMO with free dependents, Group Life Insurance, Retirement Plan, and shift allowance
  • Allowances & Support:
    Company-provided equipment, non-taxable allowances, Christmas gifts
  • Rewards & Recognition:
    Annual Performance Bonus, Compensation Review
  • Growth & Balance:
    Learning & Development Programs with strong focus on Work-Life Balance
  • Office Perks:
    Free snacks and drinks, play area, etc.

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