Healthcare Credentialing & Enrollment Specialist

AGSI; Philippines; On-site; PHP 300,000 - 460,000; Full time

Job summary

AGSI in the Philippines seeks a Credentialer to manage credentialing, recredentialing, and insurance enrollment for healthcare providers, ensuring timely submissions and payer compliance.

You will coordinate with providers, insurers, and internal teams; verify licenses, NPI, CAQH, and other documents; and maintain up-to-date credentialing records.

The role requires attention to detail, strong follow-up, and clear communication, plus the ability to handle multiple providers and deadlines.

Qualifications

• Experience in healthcare credentialing, provider enrollment, medical billing, or healthcare administration.
• Familiarity with CAQH, NPI, PECOS, Medicare, Medicaid, and commercial payers.
• Strong attention to detail and documentation skills.

Responsibilities

• Manage credentialing, recredentialing, and enrollment with commercial and government payers.
• Collect, verify, and maintain provider credentials (licenses, certifications, NPI, CAQH, malpractice).
• Complete and submit insurance enrollment and credentialing applications on time.
• Monitor application status, follow up with payers, resolve missing information.
• Communicate with providers and internal teams about requirements and status.
• Maintain accurate credentialing records and track expirations.
• Coordinate with insurance representatives and payer portals for updates.
• Ensure compliance with payer, regulatory, and organizational requirements.
• Prepare reports on credentialing status, expirations, and outstanding items.
• Handle calls and email correspondence with providers, payers, and stakeholders.

Skills

Healthcare credentialing

Provider enrollment

Medical billing

Healthcare administration

CAQH familiarity

NPI familiarity

PECOS familiarity

Medicare/Medicaid knowledge

Strong communication

Tools

CAQH portal

Payer portals

NPI registry

Job description

AGSI in the Philippines seeks a Credentialer to manage credentialing, recredentialing, and insurance enrollment for healthcare providers, ensuring timely submissions and payer compliance.

You will coordinate with providers, insurers, and internal teams; verify licenses, NPI, CAQH, and other documents; and maintain up-to-date credentialing records.

The role requires attention to detail, strong follow-up, and clear communication, plus the ability to handle multiple providers and deadlines.