Senior Credentialing Lead - Revenue Cycle Expert

Medusind; Hinoba-an; On-site; PHP 4,378,000 - 6,879,000; Full time

Job summary

Medusind is seeking a Senior Client Service Executive to oversee provider credentialing and re-credentialing, ensuring timely submissions and accuracy in payer portals. You will lead a team, maintain provider data, verify NPI, CAQH, state licenses, and manage communications with payers and internal teams.

You will collaborate with the AR team to resolve denials, support revenue cycle, and ensure ongoing provider eligibility for billing in a fast-paced healthcare environment.

Qualifications

• Bachelor's degree in healthcare administration or related field required or preferred.
• Experience in AR, credentialing, and enrollment within US healthcare essential.
• Strong leadership, organizational, and time-management skills.
• Proficiency with credentialing systems and payer portals; ability to learn new tools quickly.

Responsibilities

• Manage and lead a team of credentialing specialists, providing guidance and support.
• Handle end-to-end provider credentialing and re-credentialing, ensuring timely and accurate submissions.
• Maintain and update provider data in internal systems and payer portals, keeping records up-to-date.
• Verify provider information, including NPI, CAQH, state license, DEA, and malpractice insurance, for accuracy.
• Track credentialing applications and follow up with payers to obtain approval status promptly.
• Collaborate with the AR team to address denials or payment delays due to credentialing issues, ensuring smooth revenue flow.
• Maintain comprehensive documentation of all credentialing activities, ensuring compliance with payer requirements.
• Communicate regularly with providers and internal teams, providing status updates and requesting missing documentation.
• Support the revenue cycle by keeping providers active and eligible with payers, minimizing billing disruptions.

Skills

Leadership

Communication

Time management

Analytical thinking

Problem solving

Education

Bachelor's degree in healthcare administration or related field

Tools

Credentialing software

Job description

Medusind is seeking a Senior Client Service Executive to oversee provider credentialing and re-credentialing, ensuring timely submissions and accuracy in payer portals. You will lead a team, maintain provider data, verify NPI, CAQH, state licenses, and manage communications with payers and internal teams.

You will collaborate with the AR team to resolve denials, support revenue cycle, and ensure ongoing provider eligibility for billing in a fast-paced healthcare environment.