Provider Relations & Accreditation Specialist

MEDICARE PLUS, INC.; Pasig; On-site; PHP 250,000 - 350,000; Full time

Job summary

MEDICARE PLUS, INC. is seeking a skilled professional to manage provider networks and accreditation workflows. You will generate prospective providers, process accreditation for hospitals and clinics, and handle MOA submissions, LOA forms, and provider communications.

The role requires strong customer service experience, keen attention to detail, and solid MS Office proficiency to ensure accurate documentation and timely approvals.

Qualifications

• Preferably with at least 2 years of work experience in customer service.
• Above-average communication and interpersonal skills.
• Must be customer-service oriented.
• Must have a keen eye for details.
• Good negotiating skills.
• Proficient in MS Office Applications.

Responsibilities

• Generate prospective providers through calling and following up with the network of providers (hospitals, clinics, dentists, doctors).
• Process accreditation of hospitals, clinics, dentists, and doctors.
• Follow up with providers about the status of accreditation.
• Submit memorandum of agreement (MOA) for review and approval of prospective providers.
• Check and enroll members for dental availments.
• Check and schedule members for annual physical examination (APE).
• Provide Letter of Authorization (LOA) forms in accredited clinics and hospitals.
• Evaluate the application of new providers in terms of completeness and validity of requirements.
• Perform ocular inspection of the provider facility.
• Draft provider’s new and renewal contracts.
• Report changes requested by the providers to the management for approval.

Skills

Customer service

Communication skills

Interpersonal skills

Detail oriented

Negotiation skills

MS Office

Tools

MS Office

Job description

MEDICARE PLUS, INC. is seeking a skilled professional to manage provider networks and accreditation workflows. You will generate prospective providers, process accreditation for hospitals and clinics, and handle MOA submissions, LOA forms, and provider communications.

The role requires strong customer service experience, keen attention to detail, and solid MS Office proficiency to ensure accurate documentation and timely approvals.