
Credentialing Specialist
1 day ago
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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