Credentialing Associate

4 days ago

Manila, National Capital Region, Philippines HealthRecon Connect LLC Full time

HealthRecon Connect provides technology-enabled Revenue Cycle Management (RCM) solutions to US healthcare providers. We leverage over 30 years of deep domain expertise, cutting-edge analytics as well as machine learning, Artificial Intelligence and Automated workflows to help improve cashflow, patient outcomes and enable peace of mind for our clients.

At HealthRecon Connect (HRC), we hold ourselves accountable for setting and maintaining high standards. Day after day, we passionately strive for high achievement; for customer delight and thrive on the challenge of high expectations and commitment to excel.

Responsibilities

  • Credentialing application submission & follow up to be carried out efficiently according to the daily production targets specified by management.
  • Generate credentialing reports, analyze and work based on priority levels
  • Download/ verify correspondences related to credentialing function from Box folder/ SFTP/ EHR.
  • Ensure daily credentialing follow ups carried out as expected.
  • Ensure proper analysis being done before reaching out to insurance representatives and resolve internal gaps are identified eliminated.
  • Develop a Credentialing Plan and Root Cause analysis and share with management review
  • Ensure payer approval rate is achieved as expected for the assigned client/s
  • Act as the point of contact for assigned client for internal and external queries
  • Ensure QA reports are reviewed, fixed and responded back to the QA teams within 24 hours.
  • Ensure to responded back to all internal e-mails within the shift time
  • Daily and Weekly assigned reports to be shared within the given timelines.
  • Ensure to update SOPs in a timely manner and according to the required level.
  • Conduct random QA on a percentage decided by the management.
  • Perform QA daily if allocated and ensure to share QA reports with the relevant personnel.
  • Credentialing payers follow up and call quality to be maintained at 98% accuracy or greater.
  • Conduct training to newcomers on the job specific functions.

Qualifications

  • Partially qualified in any degree / professional qualification.
  • 2+ years' experience in RCM Operations and at least six months experience in Credentialing.
  • RCM Billing Operations knowledge will be an advantage.
  • Ability to work with MS Office package.
  • Good written and verbal communication skills.
  • Ability to work under pressure.

Details:

Work Week: Monday to Friday

Shift: Night shift (7:30 PM to 4:00 AM) - MNL

Workplace Type : Remote

Other Features: Full Time | US calendar applicable

Please send us your CV to with the designation as the subject line "Credentialing Associate "

HealthRecon Connect is an equal opportunity employer.

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