Credentialing Specialist

Proselect Management Inc; Taguig; On-site; PHP 279,000 - 469,000; Full time

Job summary

A healthcare services provider in Metro Manila seeks an experienced professional to support provider onboarding and compliance audits. The ideal candidate should have a High School diploma and preferably a Bachelor’s degree in Business or Healthcare, along with knowledge of credentialing regulations. Experience in medical staff services is essential. This role is crucial for ensuring accuracy in provider information within a dynamic healthcare environment.

Qualifications

• Proven experience in medical staff services or a CVO.
• Familiarity with credentialing regulations and accreditation standards.
• Experience with HR background checks in healthcare.

Responsibilities

• Support onboarding/offboarding for providers.
• Conduct compliance audits and prepare reports.
• Ensure accuracy of provider information.
• Process provider access requests.
• Help improve department policies and workflows.

Skills

Attention to detail

Communication skills

Knowledge of credentialing regulations

Education

High School diploma or GED

Bachelor’s degree in Business, Healthcare, or related field

CPCS or CPMSM certification

Job description

Responsibilities

• Support onboarding/offboarding by processing provider applications, monitoring expiring credentials, and updating demographic data.
• Conduct or assist with compliance audits and prepare basic reports.
• Ensure accuracy of provider information, follow disclosure guidelines, and perform quality checks as needed.
• Process provider access requests and escalating issues to leadership or the Medical Staff Office when necessary.
• Help improve department policies, procedures, and workflow.

Qualifications

• High School diploma or GED required.
• Bachelor’s degree in Business, Healthcare, or related field preferred.
• CPCS or CPMSM certification (preferred).
• At least 1 year of experience in medical staff services or a CVO (preferred).
• Knowledge of credentialing regulations and accreditation standards.
• Experience with HR background checks or employment verification in healthcare (preferred).