Credentialing Specialist

Overview:
We are a U.S.-based medical billing and revenue cycle management company seeking a Credentialing Specialist based in the Philippines. As the primary point of contact for credentialing matters, you will liaise with clients, practice administrators, and internal teams to deliver exceptional service.

Responsibilities:
- Credential providers with health plans, hospitals, and patient care facilities.
- Maintain current provider data in credentialing databases, ensuring timely license and certification renewals.
- Develop and manage detailed credentialing grids for network participation clarity.
- Verify healthcare professionals' credentials in compliance with state and federal standards, involving verification with universities, licensing agencies, and certification groups.
- Process re-credentialing paperwork and maintain a database of practitioners' training, education, licensing, and experience information.
- Ensure practitioners adhere to staff policies, department regulations, and government laws.

Qualifications and Skills:
- Strong multitasking abilities with a track record of managing multiple projects simultaneously.
- Familiar with the US medical insurance industry
- Minimum of 2 years experience in US-based Credentialing process
- Ability to build and maintain effective relationships with providers, management, staff, and external contacts.
- Demonstrated history of completing credentialing projects from start to finish.
- Project management skills with the ability to supervise others' work.
- Adherence to instructions and payer-specific guidelines.
- Highly organized and meticulous in maintaining digital files and relevant information.
- Excellent verbal and written communication skills for letters, memos, and emails.
- High comfort level working on Eastern or Pacific Time Zone/US Shift
- Good internet access at home at least 25 MBPS

We'd love to get to know you better! Please send us a brief 1-minute intro video along with your application. Please share a Google drive link for your video. Thanks!