Healthcare Licensing and Credentialing

7 days ago


Philippines Global Finance Teams Full time

Summary:
Responsible for verifying provider licensing and credentials, managing payer enrollment, and ensuring compliance with healthcare standards. Supports timely credentialing and re-credentialing for providers.

Responsibilities:

  • Collect and verify provider documents (licenses, education, certifications, malpractice, etc.).
  • Process credentialing and re-credentialing applications with payers (Medicare, Medicaid, commercial plans).
  • Maintain provider files, databases, and systems (e.g., CAQH, NPPES, PECOS).
  • Track expirations and ensure timely renewals.
  • Communicate application status and requirements to providers and internal teams.
  • Ensure compliance with HIPAA, NCQA, Joint Commission, and other regulations.

Qualifications:

  • Experience in healthcare credentialing or provider enrollment preferred.
  • 2+ years in Behavioral Health credentialing
  • Experience working in Modio credentialing database
  • Knowledge of CAQH, PECOS, and payer requirements is an advantage.
  • Strong attention to detail, organization, and communication skills.
  • Proficient with Microsoft Office and credentialing systems.
  • Willing to work US hours from Monday to Friday
Benefits

Why join us as?

You'll see dozens of marketing analysis set-ups, you'll learn how marketing strategies are built, what matters, and why. You'll have the opportunity of solving real customer problems on an everyday basis.



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