Healthcare Provider Enrollment and Credentialing Specialist

15 hours ago

Taguig, National Capital Region, Philippines Access Healthcare Services Manila, Inc. Full time ₱1,200,000 - ₱2,400,000 per year

Access Healthcare is currently looking for Provider Enrollment and Credentialing specialist to be part of our growing team.

The Provider Enrollment and Credentialing Specialist is responsible for managing the process of enrolling healthcare providers into insurance networks and ensuring that their credentials meet industry standards. This role ensures that healthcare professionals are properly credentialed to provide services, meet regulatory and payer requirements, and support operational efficiency within a healthcare organization.

Responsibilities:

  • Completion of Enrollment Activities (including, but not limited to, online applications, roster completion, CAQH, PDF applications needed to enroll a provider (physician group) with a payer), provided all information for enrollment to take place (including, but not limited to, access to a payer portal, access to Availity, and CAQH user name and passwords, in addition to all information needed to enroll, including signature pages).
  • Provider credentialing services shall also include review, documentation and follow-up with payers.
  • Once cleared, you will continue to perform Credentialing Activities – Completion of Enrollment Activities to Client as stated above.
  • Credentialing Specialist shall assist Client in enrolling the providers (physician groups) with the specified payers.
  • Credentialing services shall also include review, documentation and follow-up with payers until the providers are enrolled with the payers.

Qualifications:

  • Must have experience in Provider Enrollment and Credentialing processes for US healthcare customers.
  • Strong knowledge of Payer Processes and Credentialing
  • Prior experience of working in a medical billing company and use of medical billing software is a definite advantage.
  • Must be amenable to work onsite at McKinley, Taguig and night shift schedule

Benefits:

  • Annual Salary Increase (based on performance)
  • 20% Night Differential
  • HMO on Day 1
  • Life Insurance on Day 1
  • Free Shuttle

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