Provider Credentialing & Enrollment – Medallion/CredentialStream Experience

Access Healthcare Services Manila, Inc.; Taguig; Sur place; PHP 350 000 - 520 000; Plein temps

Avantages offerts par ce poste

Annual Salary Increase

20% Night Differential

HMO on Day 1

Life Insurance on Day 1

Free Shuttle

Résumé du poste

Access Healthcare Services Manila, Inc. is seeking a Provider Enrollment and Credentialing Specialist to join our growing team in Taguig. You will manage enrollment with payers, ensure provider credentials meet regulatory standards, and support efficient operations.

Responsibilities include CAQH enrollment, payer portal access, and credentialing follow-up. On-site night shift experience and US healthcare familiarity are preferred to ensure smooth payer interactions.

Qualifications

• Must have experience in Provider Enrollment and Credentialing for US healthcare customers.
• Experience with Medallion and CredentialStream is required.
• Strong knowledge of payer enrollment and credentialing processes.
• Experience in medical billing software is a plus.

Responsabilités

• Completion of Enrollment Activities including CAQH, online applications, roster completion, and PDFs for payer enrollment.
• Credentialing services include review, documentation and follow-up with payers.
• Continue Enrollment and Credentialing activities for clients after clearance.
• Assist clients in enrolling physician groups with specified payers.
• Credentialing services include follow-up with payers until enrollment is complete.

Connaissances

Enrollment & Credentialing experience

Payer processes knowledge

Medical billing exposure

Night shift readiness

Outils

Medallion

CredentialStream

Availity

Description du poste

Access Healthcare is currently looking for Provider Enrollment and Credentialing specialist to be part of our growing team.
The Provider Enrollment and Credentialing Specialist is responsible for managing the process of enrolling healthcare providers into insurance networks and ensuring that their credentials meet industry standards. This role ensures that healthcare professionals are properly credentialed to provide services, meet regulatory and payer requirements, and support operational efficiency within a healthcare organization.

Responsibilities

• Completion of Enrollment Activities (including, but not limited to, online applications, roster completion, CAQH, PDF applications needed to enroll a provider (physician group) with a payer), provided all information for enrollment to take place (including, but not limited to, access to a payer portal, access to Availity, and CAQH user name and passwords, in addition to all information needed to enroll, including signature pages).

• Provider credentialing services shall also include review, documentation and follow-up with payers.

• Once cleared, you will continue to perform Credentialing Activities – Completion of Enrollment Activities to Client as stated above.

• Credentialing Specialist shall assist Client in enrolling the providers (physician groups) with the specified payers.

• Credentialing services shall also include review, documentation and follow-up with payers until the providers are enrolled with the payers.

Qualifications

• Must have experience in Provider Enrollment and Credentialing processes for US healthcare customers.

• Must have experience in Medallion and CredentialStream

• Strong knowledge of Payer Processes and Credentialing

• Prior experience of working in a medical billing company and use of medical billing software is a definite advantage.

• Must be amenable to work onsite at McKinley, Taguig and night shift schedule

Benefits

• Annual Salary Increase (based on performance)

• 20% Night Differential

• HMO on Day 1

• Life Insurance on Day 1

• Free Shuttle