Credentialing Specialist

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