Credentialing Specialist

2 days ago


Cebu City, Central Visayas, Philippines Hirebiz Med Full time ₱336,000 per year

Job Title: Medical Insurance Billing & Credentialing Specialist

Job Summary:

We're seeking a detail-oriented and organized professional to manage healthcare provider credentialing, re-credentialing, and billing functions. This role ensures providers are properly enrolled with insurance networks and maintains compliance with regulatory standards.

Key Responsibilities:

  • Process initial credentialing and re-credentialing for healthcare providers.
  • Verify licenses, certifications, education, and other credentials.
  • Maintain accurate and up-to-date credentialing and licensing records.
  • Ensure compliance with all regulatory and payer requirements.
  • Communicate with providers and insurance companies regarding credentialing status.
  • Assist with license and DEA applications.
  • Perform data entry for billing charges, payments, and claim status updates.
  • Support billing projects and identify opportunities for process improvement.

Qualifications:

  • At least 2 years of experience in medical credentialing, licensing, or billing.
  • Strong knowledge of healthcare compliance and insurance regulations.
  • Excellent communication and organizational skills.
  • Proficient in Microsoft Office; experience with credentialing systems a plus.
  • CPCS or CPMSM certification preferred but not required.

Job Types: Full-time, Permanent

Pay: Php20, Php28,000.00 per month

Benefits:

  • On-site parking

Work Location: In person



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