WFH Credentialing Specialist

BruntWork; Metro Manila; Remote; PHP 2,866,000 - 4,140,000; Full time

Benefits offered by this job

Permanent work from home

Immediate hiring

Steady freelance job

Profit sharing incentive

Paid time off

Holiday pay

Annual Performance and RaiseEvaluation

Quarterly Perfect Attendance Incentive

HMO

BruntWork Loan Assistance

Job summary

BruntWork is seeking a Credentialing Specialist to own provider enrollment end-to-end for high-complexity states. You will ensure accurate, compliant submissions for commercial and government payors and guide submissions with regulatory knowledge.

As a subject matter expert, you will prevent delays, maintain documentation, and communicate proactively with clients and internal teams to anticipate re-credentialing timelines and keep all stakeholders informed.

Qualifications

• Two years of college completed or pursuing coursework.
• Experience in US-based medical billing or credentialing is required.
• Strong attention to detail and ability to work with regulatory guidance.
• Excellent written and verbal communication in a professional setting.

Responsibilities

• Lead submission of provider enrollment applications for complex states.
• Serve as SME for credentialing and enrollment requirements.
• Maintain knowledge of in-network and out-of-network processes.
• Validate provider data with Account Coordinators before enrollment.
• Build relationships with payor representatives to resolve issues.
• Submit provider enrollment docs via portals or mail.
• Track status and perform proactive follow-ups for timely approvals.
• Manage re-credentialing and inform management of requirements.
• Complete payor attestations to ensure compliance.
• Provide daily status reports on workload and staff support.
• Document all submissions and correspondence in tracking systems.

Skills

Attention to detail

Critical thinking

Strong communication

Deadline-driven

Fast learner

Education

Two years of college

Tools

Payor portals

Internal tracking systems

Medical billing software

Job description

Job Overview:

Our client is looking for a Credentialing Specialistto take confident, end-to-end ownership of provider enrollment for assigned high-complexity states. In this role, you will ensure that provider enrollment applications for both commercial and government payors are submitted accurately, compliantly, and within expected turnaround times. As the subject matter expert, you will leverage a deep understanding of state-specific requirements to guide submissions, resolve issues, and navigate complex regulatory environments with minimal need for escalation. Ultimately, Clients, Account Teams, and internal leadership will experience your workflow as reliable, organized, and proactive as you anticipate re-credentialing timelines and manage activity from initial application through final approval.

Measures of Success:

• 100% verification of required data: All client-required information is confirmed prior to initiating enrollment applications.

• Submission timeliness: New provider applications are submitted within 8 working hours of receiving complete information. Applications for new payor contracts are submitted within 3–5 business days of receiving complete information.

• Proactive communication: Daily activity and follow-up reports are consistently sent to the Credentialing Representative II or State Payor Credentialing Coordinator.

• Application accuracy: Application denial rate remains below 1% across all submissions.

Schedule:

• Monday - Thursday, 8:45 AM - 5:00 PM New York Time (8:45 PM - 5:00 AM Manila Time)

• Friday, 8:45 AM - 3:45 PM New York Time (8:45 PM - 3:45 AM Manila Time)

Responsibilities:

• Lead the submission of provider enrollment applications for assigned states with complex regulations or high provider volume.

• Serve as the primary subject matter expert for credentialing and enrollment requirements in assigned state(s).

• Maintain current knowledge of both In-network and out-of-network enrollment processes.

• Partner with Account Coordinators to validate provider data and documentation prior to initiating enrollment applications.

• Establish and maintain productive working relationships with payor representatives in assigned states to support clear communication and timely issue resolution.

• Prepare and submit provider enrollment documentation through appropriate channels, including payor portals and mailed submissions.

• Track application status and perform proactive follow-ups to drive timely approvals.

• Manage re-credentialing submissions and communicate upcoming client requirements to Account Management.

• Complete quarterly and other required payor attestations to ensure ongoing compliance.

• Provide daily status reports to Credentialing Coordinator, including updates for personal workload and any Credentialing Representative I staff supporting assigned states.

• Maintain thorough documentation of all submissions, follow-ups, and payor correspondence within internal tracking systems.

Requirements:

• Exceptional attention to detail and strong organizational skills.

• Critical thinking and problem-solving abilities in complex or ambiguous situations.

• Ability to work effectively in a fast-paced, deadline-driven environment.

• Clear and professional verbal and written communication skills.

• Strong reading comprehension and ability to interpret regulatory and procedural guidance.

• Professional yet assertive communication style when working with payors to drive timely outcomes.

• Must have own computer and stable internet connection suitable for a permanent work-from-home setup.

Qualifications:

• At least 2 years in college.

• 2 years of experience in a US-based medical billing practice OR 2 years of experience in a medical practice dealing with billing (including but not limited to provider credentialing, authorizations, reimbursement, etc.), preferably in Behavioral Health to some degree.

Core Values:

Our client hires, fires, and promotes based on these core values in addition to job-specific performance:

• Respectful of our unique cultural environment

• Absolute Confidentiality

• Embracing Teamwork

• Loyal Behavior & Positive Attitude

• Accountability

• Proactiveness

• Thoroughness

• Focused on results

• Inspired to learn & grow constantly

• Devoted to providing top-tier services to clients through "Unique Service Oriented Philosophies"

Independent Contractor Perks:

• Permanent work from home

• Immediate hiring

• Steady freelance job

• Profit sharing incentive

• Paid time off

• Holiday pay

• Annual Performance and Raise Evaluation

• Quarterly Perfect Attendance Incentive

• HMO

• BruntWork Loan Assistance

Note:

Please note that since this is a permanent work-from-home position and an “Independent Contractor” arrangement, candidates will handle their own benefits and taxes.