Hybrid Credentialing Analyst - Payer Contracts & Compliance

Hammerjack Pty Ltd; Philippines; Hybride; PHP 500 000 - 900 000; Plein temps

Résumé du poste

Hammerjack Pty Ltd in the Philippines seeks a Credentialing Compliance Analyst to review managed care contracts, verify provider data, and ensure regulatory adherence. You will support payer relations, enrollment processes, and contract management across internal teams and external partners.

The role requires strong analytical skills, experience in US healthcare, and proficiency with MS Office. Hybrid work setup and night shift schedule are offered in a mission-driven environment.

Qualifications

• Bachelor's degree in Business Administration, Healthcare Administration, Finance, Information Systems, or related field.
• Experience in US healthcare, preferably supporting managed care, provider operations, payer relations, revenue cycle.
• Experience in provider credentialing and enrollment processes, including verification of provider information.
• Working knowledge of managed care contracts, reimbursement methodologies, payer policies, and claims processes.
• Familiarity with credentialing, provider data management, contract management, and healthcare information systems.
• Strong analytical and problem-solving skills with the ability to interpret complex healthcare contracts.

Responsabilités

• Review and maintain managed care contracts to ensure compliance with standards and regulations.
• Serve as a resource for contract terms, payer policies, and reimbursement methodologies.
• Maintain contract repositories, fee schedules, and payer policy inventories.
• Analyze contract language and payer communications for business impact.
• Research and resolve payer-related issues, disputes, and claims inquiries.
• Coordinate with stakeholders to support contract implementation and compliance monitoring.
• Prepare reports and analyses regarding managed care agreements and payer performance.
• Identify opportunities to improve contract management efficiency and standardization.

Connaissances

US healthcare

Credentialing & enrollment

Payer policies

Analytical skills

Stakeholder mgmt

Provider data mgmt

Contract mgmt

Formation

Bachelor's degree in related field

Outils

Microsoft Office

Description du poste

Hammerjack Pty Ltd in the Philippines seeks a Credentialing Compliance Analyst to review managed care contracts, verify provider data, and ensure regulatory adherence. You will support payer relations, enrollment processes, and contract management across internal teams and external partners.

The role requires strong analytical skills, experience in US healthcare, and proficiency with MS Office. Hybrid work setup and night shift schedule are offered in a mission-driven environment.