Credentialing Assistant – US Healthcare (Payer Enrollment & Portal Management)

About Us:
We’re a US-based healthcare startup supporting a fast-growing network of medical providers across multiple states. As we continue to scale, we're looking for a detail-oriented Credentialing Assistant based in the Philippines to support our enrollment and payer management operations. If you have experience navigating complex healthcare systems, enrolling providers, and ensuring claims flow smoothly, we’d love to hear from you.

What You’ll Do:
As a Credentialing Assistant, you’ll play a vital role in supporting provider onboarding, maintaining accurate payer enrollments, and resolving issues that affect claim processing. Your responsibilities will include:

Enrolling new providers with commercial and Medicaid payers, including through Availity and direct payer portals

Managing and maintaining payer portal access for multiple providers

Submitting claims, tracking status, and resolving submission issues via Optum Clearinghouse

Completing and updating EFT and ERA enrollments across a wide range of insurance payers

Handling initial credentialing, re-credentialing, demographic updates, and other maintenance tasks

Working with Medicaid MCOs and HMOs, particularly in NJ, NY, VA, MD, CA, MT, NE, AK, and other states

Navigating New Jersey-specific payers such as Horizon NJ Health, Aetna Better Health, and UnitedHealthcare Community Plan

Identifying and resolving credentialing and billing issues, including NPI linkage errors, taxonomy mismatches, and payer-specific compliance requirements

What We’re Looking For:

2+ years of experience in provider credentialing or payer enrollment in US healthcare

Proficiency with Availity and Optum Clearinghouse

Experience working with Medicaid MCOs and commercial HMOs, especially in high-volume states like New Jersey

Solid understanding of credentialing workflows and payer requirements

Strong attention to detail, organizational skills, and follow-through

Ability to work independently and meet deadlines

Excellent English communication skills

Preferred but Not Required:

Fully filled-out OnlineJobs.ph profile

ID Proof of 70+

Completed IQ, English, and DISC assessments

Schedule & Compensation:

Full-time, long-term remote role

Flexible hours with some availability during US business time

Competitive hourly rate based on experience

How to Apply:
To be considered, please send:

Your updated resume

A brief description of your credentialing experience, including the states and payers you've worked with

A short intro video (1–2 minutes) about your background and how you can help our team

The word “CREDREADY” at the top of your message so we know you read the listing carefully

We’re excited to find someone who’s organized, reliable, and ready to keep our credentialing operations running smoothly!