Credentialing Specialist

We are seeking a highly organized and detail-oriented Credentialing Specialist to support the accurate and timely processing of provider credentialing and re-credentialing functions. The ideal candidate has at least two years of experience in the healthcare industry and a strong understanding of credentialing standards, regulatory requirements, and payer enrollment processes.

Key Responsibilities

• Manage the full credentialing and re-credentialing lifecycle for healthcare providers, ensuring compliance with organizational, state, and federal requirements.
• Collect, verify, and maintain all provider documentation, including licenses, certifications, education, training records, and work history.
• Prepare and submit credentialing applications to payers, hospitals, and regulatory agencies with a high level of accuracy.
• Monitor application progress, perform timely follow-ups, and resolve discrepancies or delays.
• Maintain and update credentialing databases, trackers, and reports to ensure data integrity.
• Ensure adherence to credentialing standards such as CAQH, CMS, Joint Commission, and NCQA guidelines.
• Communicate professionally with providers, internal teams, payers, and external partners regarding credentialing requirements, updates, and status inquiries.
• Assist in audits, compliance reviews, and ongoing quality assurance activities.

Qualifications

• Minimum of 2 years of experience in healthcare, preferably in credentialing, provider enrollment, medical staffing, or related functions.
• Strong knowledge of credentialing processes, payer requirements, and regulatory standards.
• Proficiency with credentialing software, databases, and Microsoft Office applications.
• Exceptional attention to detail, organizational skills, and ability to manage multiple deadlines.
• Strong written and verbal communication skills.
• Ability to maintain confidentiality and handle sensitive information with discretion.
• Experience with payer enrollment and hospital privileging processes.
• Familiarity with CAQH, NPI, DEA, and other provider data management systems.

Work-from-Home Device Requirement

• Device: Personal computer with Intel Core i5 or higher, or AMD Ryzen 5 or higher
• Internet: Wired connection with at least 50 Mbps download speed, plus a backup connection (e.g., mobile hotspot or prepaid Wi-Fi)
• Work Environment: Quiet, well-lit space with minimal background noise

Benefits

• Permanent Work From Home
• Weekly Paychecks
• Fixed Weekends Off
• HMO Reimbursement on your 90th day
• Thriving Company Culture with Complete Autonomy
• Exclusive Specialized Training Programs
• Unlock Your Potential with a Highly Competitive Salary

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Who are we?
MedCore Solutions is the healthcare division of BizForce, dedicated to supporting U.S.-based healthcare clients through a skilled remote workforce in the Philippines. We specialize in connecting top clinical and administrative talent with reputable healthcare organizations, ensuring high-quality care delivery while providing rewarding work-from-home careers.

Why work for Bizforce?
Bizforce is a global remote workforce solutions company currently partnering with some of the largest Architectural and Engineering firms in the world. If you are looking to advance your career and improve your skills with an industry leader, we encourage you to apply today Bizforce was founded with one goal – to deliver dependable high-quality skilled labor and business processes to US-based companies at affordable prices. Bizforce has grown rapidly and allows the best talent in PH to work remotely from home with the latest technology and resources. BizForce is proud to partner with PH to deliver qualified, professional workers, giving our Architects and Engineers the ability to have an unbeatable career and work from home.