We are looking for a seasoned Credentialing Specialist to join our team!
Credentialing Specific Skills:
- Process and file applications with third party payors according to each payors individual requirements and addresses/corrects discrepancies as requested by payors.
- Conduct all follow up steps till payor approval/completion is obtained.
- File provider practice change notifications and perform follow up duties till confirmed complete by payors.
- Update NPI records according to provider specifications.
- Enroll provider in Medicare/Medicaid as prescribed by each program requirements.
- Track provider licensure and Board expirations and ensures timely processing CAQH, and payor updates.
- Complete requests for re-credentialing for both providers and facilities.
- Accept and process all requests from payers for credentialing information/updates/new contracts and products
- Answer questions, process requests from staff/providers related to credentialing information.
- Address enrollment disconnects in regards to facility and providers
- Complete ERA/EFT enrollment, tracking and filing, Clearinghouse (Availity RCM, CAQH Enroll hub)
- Maintains in quarterly CAQH mass attestation
- Serves as liaison between outside organizations and external customers.
Salary: PHP 35,000 – PHP 40,000