RCM and Credentialing Supervisor

4 days ago

Taguig, National Capital Region, Philippines PMC Recruitment Full time

Revenue and Credentialing Supervisor

BGC, Taguig | Onsite | Night shift

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The role is responsible for leading and managing the administrative team handling provider credentialing and enrollment for managed care and reimbursement. This person ensures that all credentialing and enrollment processes are accurate, compliant, and timely, while mentoring the team and optimizing workflows and systems.

This is a leadership role that requires strong knowledge of healthcare credentialing, payer systems, and regulatory requirements.

Key Responsibilities:

Team Leadership & Supervision

  • Oversee day-to-day operations of the credentialing/administration team for both managed care and reimbursement.
  • Supervise, mentor, and provide performance feedback to credentialing analysts and specialists.
  • Develop team capabilities through coaching, mentoring, and formal evaluations.
  • Set performance goals and address gaps promptly.

Credentialing & Enrollment Oversight

  • Monitor team productivity, credentialing timelines, and payer-specific requirements to ensure efficiency and compliance.
  • Serve as an escalation point for complex or delayed enrollments, directly liaising with payers to resolve issues.
  • Manage and optimize credentialing software and data systems, maintaining data integrity and reporting accuracy.
  • Maintain knowledge of industry regulations and changes affecting credentialing (CMS, Medicaid, commercial payers).

Reporting & Compliance

  • Generate regular reports and dashboards for leadership, including KPIs and risk indicators.
  • Support internal audits and reviews related to credentialing and provider enrollment.
  • Ensure compliance with all payer-specific and regulatory requirements.

Must-Have Qualifications

  • Bachelor's degree in Business, Health Administration, or a related field.
  • 7+ years' experience in healthcare environments with provider credentialing or enrollment.
  • Experience managing credentialing in a large multi-specialty group, hospital system, or health plan.
  • Strong knowledge of CAQH, PECOS, NPPES, and payer-specific enrollment systems.

Job Type: Full-time

Pay: Up to Php135,000.00 per month

Benefits:

  • Paid training

Ability to commute/relocate:

  • Taguig: Reliably commute or planning to relocate before starting work (Preferred)

Experience:

  • Revenue/Healthcare credentialing or enrollment: 7 years (Preferred)
  • Supervisory: 2 years (Preferred)
  • Healthcare: 1 year (Preferred)

Work Location: In person

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