Senior Credentialing Specialist: Healthcare Enrollment

MCVO Talent Outsourcing Services; Philippines; Sur place; PHP 500 000 - 900 000; Plein temps

Résumé du poste

MCVO Talent Outsourcing Services seeks a Senior Credentialing Specialist to ensure accurate credentialing and re-credentialing of healthcare providers across networks, with emphasis on compliance and timely documentation.

You will lead credentialing processes, coordinate with providers, payers, and clearinghouses, and train new staff while maintaining meticulous records in credentialing software and Microsoft Office tools.

Qualifications

• 5+ years of experience in healthcare credentialing.
• End-to-end knowledge of provider and facility enrollment and regulations.
• Experience managing Medicare, Medicaid, and commercial payers enrollment.
• Proficient with PECOS, CAQH and payer portals.

Responsabilités

• Prepare, submit, and track provider enrollment applications for payers.
• Perform primary source verifications and maintain credentialing records.
• Liaise with providers, payers, and clearinghouses to resolve issues.
• Train new team members on credentialing processes.

Connaissances

Healthcare credentialing

Communication skills

Organization/detail orientation

Multitasking

Team collaboration

Formation

Associate’s degree in healthcare administration

Outils

PECOS

CAQH

Insurance carrier platforms

Microsoft Office

Description du poste

MCVO Talent Outsourcing Services seeks a Senior Credentialing Specialist to ensure accurate credentialing and re-credentialing of healthcare providers across networks, with emphasis on compliance and timely documentation.

You will lead credentialing processes, coordinate with providers, payers, and clearinghouses, and train new staff while maintaining meticulous records in credentialing software and Microsoft Office tools.