Credentialing Specialist (US Healthcare) | Get a 21K Signing Bonus at ISTA Solutions Inc

Mandaluyong, Metro Manila, Philippines -

Full Time

Start Date

Immediate

Expiry Date

06 Aug, 26

Salary

0.0

Posted On

08 May, 26

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Credentialing, Provider Enrollment, Insurance Verification, CAQH, NPI, PECOS, HIPAA Compliance, Microsoft Excel, Microsoft Outlook, Healthcare Administration, Data Entry, Communication Skills, Organization Skills, Payer Portal Management, Record Maintenance, Reporting

Industry

Outsourcing and Offshoring Consulting

Description

ISTA Solutions, an outsourcing/offshoring company, is in search of an experienced Healthcare Customer Service Representative to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals, who prioritize employee satisfaction and work-life balance. At ISTA Solutions, we pride ourselves on creating a culture focused on long-term success and life-long learning. We're looking for a team player who is ready to contribute to our mission, just like you! Account specific roles and responsibilities: Process initial credentialing, recredentialing, and payer enrollment applications for healthcare facilities and providers Coordinate with insurance companies, managed care organizations, Medicare, Medicaid, and commercial payers regarding credentialing requirements and application status Maintain accurate provider and facility records within credentialing databases and tracking systems Gather, verify, and organize required credentialing documentation such as licenses, certifications, malpractice insurance, W-9s, NPIs, and CAQH profiles Conduct regular follow-up with payers to ensure timely processing and approval of applications Monitor credentialing expiration dates and support timely renewals and revalidations Update and maintain CAQH profiles and payer portals Review applications for completeness and accuracy prior to submission Communicate credentialing status updates to internal stakeholders and clients Assist in resolving credentialing-related issues, denials, or discrepancies Ensure compliance with payer requirements, company policies, HIPAA regulations, and credentialing standards Generate reports and maintain credentialing trackers as needed At least 1 year of experience in US healthcare credentialing, provider enrollment, or insurance verification Experience handling facility credentialing and payer enrollment processes preferred Familiarity with Medicare, Medicaid, commercial insurance payers, and MCO credentialing processes Knowledge of CAQH, NPI, PECOS, and payer portals preferred Strong attention to detail and organizational skills Excellent written and verbal communication skills Ability to manage multiple applications and deadlines simultaneously Proficient in Microsoft Office tools, particularly Excel and Outlook Must be willing to work on-site in Shaw Blvd, Mandaluyong Amenable working night shifts What Can We Offer You? Competitive salary and benefits Health Insurance with free dependents* 10%-night differential Attendance Bonus Paid Time Off Convertible to cash leave credits Performance Appraisal Work-life balance A focus on growing your career path with us We encourage you to follow your passions and learn new skills Our Commitment to You Strong culture and values-driven leadership We create opportunities for you to learn and grow at any stage of your career Continuous learning and innovation We foster an all-inclusive environment where everyone thrives

Responsibilities

Process initial and re-credentialing applications for healthcare providers and facilities while coordinating with insurance payers. Maintain accurate provider records and ensure compliance with HIPAA regulations and payer standards.