Provider Credentialing Specialist (Part-Time)

Global Finance Teams; Makati; Remoto; PHP 1.042.000 - 1.736.000; Part-time

Descrizione del lavoro

Global Finance Teams is seeking a Provider Credentialing Specialist to support Clinical and Operations by maintaining accurate, audit-ready credentialing files for providers. You will review files, manage CAQH profiles, renew licenses and compliance documents, and coordinate across time zones in a remote, part-time role.

Strong attention to detail and communication are essential. The position offers flexible hours and a DOE compensation structure, suitable for independent contractors seeking

Competenze

• 1–2+ years of credentialing experience, ideally within behavioral or mental health.
• Experience managing CAQH Provider Profiles.
• Proficient with Airtable and Google Sheets.
• Excellent written and verbal communication, with strong attention to detail.

Mansioni

• Review credentialing files and obtain missing, incomplete, or expiring information.
• Update CAQH profiles and maintain credentialing records in the database.
• Complete credentialing and re-credentialing applications; monitor and follow up as needed.
• Maintain current state licenses, malpractice coverage, and other required documents for all providers.
• Conduct license checks and maintain up-to-date records of all provider licenses.
• Track license and certification expirations to ensure timely renewals.
• Maintain knowledge of health plan credentialing requirements across states where the company operates.
• Serve as a point of contact for providers, providing updates on credentialing status.
• Assist the Credentialing Committee with information and records of decisions.

Conoscenze

Credentialing experience

Communication

Strumenti

Airtable

Google Sheets

CAQH

Descrizione del lavoro

Your Responsibilities

As a Provider Credentialing Specialist, you will support the Clinical and Operations teams by keeping our providers' credentialing files accurate, current, and audit-ready.

Credentialing & Provider Files

• Review credentialing files and work with providers to obtain any missing, incomplete, or expiring information.


• Update and manage provider CAQH profiles and maintain accurate records in the credentialing database.


• Complete provider credentialing and re-credentialing applications; monitor applications and follow up as needed.


• Maintain copies of current state licenses, malpractice coverage, and other required credentialing documents for all providers.

License & Compliance Tracking

• Conduct license checks and maintain up-to-date records of all provider licenses.


• Track license and certification expirations for all providers to ensure timely renewals.


• Track provider licenses, certifications, and professional liability insurance, and ensure practice addresses stay current with health plans, agencies, and other entities.


• Maintain working knowledge of health plan credentialing requirements across the states where the company operates.

Communication & Coordination

• Serve as a point of contact for providers, giving them updates on credentialing status.


• Help compile information for the Credentialing Committee and maintain records of Committee decisions.


• Support the annual audit process that maintains delegated credentialing status with applicable health plans.

What You Will Need to Succeed

• Experience: 1–2+ years of credentialing experience, ideally within behavioral or mental health (required).


• Experience managing CAQH Provider Profiles (required).


• Experience using Airtable and Google Sheets (preferred).


• Excellent written and verbal communication skills, with strong attention to detail and organization.


• Comfort working independently and asynchronously, coordinating across time zones.


• Genuine alignment with the company's mission and values.

Role Details

• Type: Part-time, independent contractor


• Hours: [XX hours/week — TBD]


• Location: Remote


• Compensation: [Hourly rate, DOE — TBD]