Credentialing Specialist- Work From Home

Davao City, Davao del Sur, Philippines | Full-time

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Vericle Pacific is looking for full-time US Healthcare Credentialing Specialist.  Vericle Pacific, a Philippine-based company, supports Vericle Corporation, a US-based parent company.  Vericle offers revenue cycle management (RCM) service along with a practice management software (SaaS).   

 

RESPONSIBILITIES

 

Handle credentialing needs for our clients (Group and/or Individual) who are US-based health care providers, diagnostic laboratories and medical facilities as preferred providers in health care networks. This entails the following tasks:

  • Perform credentialing work:
    • Collect all the required documentation for credentialing such as accreditation, membership and facility privileges (e.g., License, NPI letter).
    • Assist providers with completing payer forms and ensure compliance with payer’s expectations
    • Respond to provider’s inquiries as to credentialing process progress
    • Alert client of new regulations, expiring certificates, reapplications and deficiencies in credentialing requirements
  • Maintain accurate and current client information using an online database
  • Drive the implementation of the automated credentialing workflow management system:
    • Provide requirements to software developers
    • Review implementation 

 

QUALIFICATIONS

  1. Minimum of 6 months experience in US-based Credentialing process
  2. Familiar with US medical insurance industry 
  3. Excellent listening, communication, and problem-solving skills
  4. Self-motivated and able to work autonomously

 

MUST HAVE:

  1. High comfort level working on Eastern Time Zone/US Shift
  2. Good internet access at home
  3. Mobile Hotspot
  4. Laptop/Desktop of at least 8 GB