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Credentialing Specialist

Job in Pasig - Philippines
Full Time position
Listed on 2020-01-28
Job specializations:
  • Healthcare
    MDS Coordinator
  • Insurance
    Insurance Compliance
Job Description & How to Apply Below
A US company based in California, is excited to recruit that handful of the high performing individuals to take the company to the next level.


Maintain compliance with all regulatory and accrediting institutions
Monitor medical/non-medical staff credentials and licenses
Advise staff on renewal procedures
Participate in the development of internal credentialing processes
Keep records in licenses, credentials and insurance contracts
Release information to agencies and members of the public as required by law
Work closely with key stakeholder to resolve operational issues in specified time frames related to payer and provider contracts.
Show a strong understanding of contract structure and terms. Serves as facilitator for the resolution of complex contract interpretation. Interface with payers on disputes related to contract interpretation.
Utilize strong communication skills, both written and oral required to research, identify root cause by communicating at various levels within the organization, consolidating the issues, and sharing the resolution.
Utilize strong organizations skills required to manage and prioritize work including multiple priorities at the same time. Tracking and communicating current workload and open issues on a regular basis to key stakeholders and leaders.
May participate with negotiators during contract negotiations, on payer issues.
Track issues identified by Revenue Cycle and other stakeholders, where system is unable to be set up correctly to administer language correctly. In collaboration with key stakeholders, develop correction action plan.
Support the annual payer contract renewal and payer notification process.
Responsible for overall contract document maintenance.
Position Requirements
Bachelor,   Less than 1 Year work experience
College graduate (Bachelor degree)
Experience with payer billing, collections and reimbursement methodologies and contract requirements preferred but not required.
Intermediate level working with in Microsoft Office
Typing speed: at least 45 words per minute
Willing to work from 6:00 am to 3:00 pm (Manila time)
Required Language Skills:
  • English - Very good
Contact Information
Contact Name: Friendlysoft Technology Inc.
Preferred method of contact: Email with CV via Application Box below.
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Philippines-only applications: This Company / Employer has indicated that only qualified candidates currently living in Philippines (and its citizens living globally) are being considered here for this position. Search Here for alternative jobs that match your location & skills.

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