Credentialing Specialist: Payer Enrollment Expert

Genius Agency AI; Philippines; On-site; PHP 2,827,000 - 4,711,000; Full time

Job summary

Global Pacific Support is seeking an experienced Credentialing Specialist to support Ready Set And Go ABA, a provider of compassionate and evidence-based Applied Behavior Analysis (ABA) Therapy services for children with autism.

The ideal candidate has experience credentialing behavior analysts and therapists with US insurance payers. The role involves processing credentialing applications, managing CAQH profiles, and maintaining licensing and payer enrollments across major networks.

Qualifications

• At least 2 years experience in US medical credentialing.
• Experience credentialing BCBA, therapists, or healthcare providers.
• Experience with CAQH, NPI registration, and payer enrollment.
• Strong knowledge of US insurance credentialing process.
• Excellent documentation and communication skills.
• Ability to work independently.

Responsibilities

• Process provider credentialing applications
• Manage CAQH provider profiles and updates
• Credential providers with insurance networks (Aetna, Cigna, UnitedHealthcare, BCBS, Tricare)
• Maintain credentialing documents and licenses
• Track credentialing status and payer approvals
• Follow up with insurance companies regarding applications
• Ensure compliance with payer and regulatory requirements

Skills

US medical credentialing

CAQH

NPI registration

Payer enrollment

Documentation

Independent work

Tools

CAQH system

Payer portals

Job description

Global Pacific Support is seeking an experienced Credentialing Specialist to support Ready Set And Go ABA, a provider of compassionate and evidence-based Applied Behavior Analysis (ABA) Therapy services for children with autism.

The ideal candidate has experience credentialing behavior analysts and therapists with US insurance payers. The role involves processing credentialing applications, managing CAQH profiles, and maintaining licensing and payer enrollments across major networks.