US Healthcare Credentialing Specialist
5 days ago
Penbrothers is an HR & remote talent management partner and one of the fastest growing companies in the Philippines. We provide talented Filipinos with global opportunities in high-growth startups and dynamic companies, from the comfort of their own homes.
About the Client
Our client is a multi-state ambulatory surgery center specializing in pediatric and special needs dentistry under general anesthesia. Their mission is to provide safe, compassionate, and efficient surgical care while creating a supportive environment for patients, families, and staff. To ensure quality care and regulatory compliance, we are seeking a detail-oriented Credentialing Specialist to join their growing team.
About the Role
The Healthcare Credentialing Specialist is responsible for managing the credentialing and re-credentialing process for all providers within our client, a leading healthcare organization. This role ensures that providers are fully compliant with state, federal, and payor requirements while maintaining accurate records and supporting the onboarding process. The ideal candidate will have strong organizational skills, an eye for detail, and experience in healthcare credentialing in a multi-state environment.
What you'll do
- Manage the initial credentialing and re-credentialing of dentists, anesthesiologists, and other providers.
- Collect, review, and verify all provider documentation, including licenses, certifications,
- malpractice insurance, and education.
- Submit credentialing applications and monitor progress with insurance companies, Medicaid, Medicare, and hospital partners.
- Maintain accurate and up-to-date credentialing files in compliance with company policies, accreditation standards, and state/federal regulations.
- Track and follow up on expiring licenses, certifications, and other credentials to ensure uninterrupted provider eligibility.
- Collaborate with HR, Compliance, and Operations teams to support provider onboarding and readiness.
- Respond to credentialing-related inquiries from providers, payors, and leadership with professionalism and accuracy.
- Assist in audits and surveys by preparing and providing necessary credentialing documentation.
- Identify opportunities to improve credentialing workflows and systems.
- At least 3 years of experience in medical or dental credentialing, preferably in an ambulatory
- surgery center or multi-site healthcare environment.
- Strong knowledge of provider credentialing processes, including CAQH, NPI, DEA,
- Medicaid, and Medicare requirements.
- Familiarity with payer enrollment and insurance verification.
- High attention to detail with strong organizational and time-management skills.
- Ability to manage multiple deadlines and priorities in a fast-paced setting.
- Strong communication skills, both written and verbal.
- Proficiency with credentialing software and Microsoft Office Suite.
- Commitment to maintaining confidentiality and compliance with HIPAA and company standards.
We utilize AI tools to enhance our hiring efficiency and ensure a fair evaluation of all candidates. As a result, candidates who passed our initial evaluations should expect an AI Interviewer as a component of our recruitment process. This is supervised by Human Talent Acquisition Experts who will also engage with you throughout your application journey.
What You'll Get
At Penbrothers, we are obsessed with creating positive employee experiences. Here you'll find an environment that nurtures learning and provides opportunities for growth. You'll have the opportunity to make an impact on fast-growing startups and dynamic companies.
- Meaningful work & Growth: We take every opportunity to stretch ourselves and deliver an excellent client experience.
- Employee as our biggest asset: We are genuinely invested in our people's career and welfare.
- Global reach & local impact: Get to work with high-growth startups and dynamic companies from the comfort of your own home.
- Powering global startups: We've created 1,400 Filipino jobs that empower global start-ups to focus on growth.
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