Job Summary:
The Credentialing Specialist will play a crucial role in ensuring the smooth operation of our pain management clinic clients by efficiently managing the licensing and certification processes. Responsible for all aspects of credentialing, re-credentialing, delegated credentialing, ongoing maintenance of credentials, reports, online verifications and administrative support of credentialing functions for all practitioners and facilities who provide service to our patients. This remote position will work closely with our US-based team to maintain accurate and up-to-date provider profiles, enabling timely billing.
Key Responsibilities:
- Provider Credentialing: Manage the entire credentialing process for our team an clients, including obtaining and verifying licenses, certifications, and other required documents.
- Application Management: Submit and track provider applications to health insurance payers, ensuring timely processing and approval.
- DEA License Management: Assist providers in obtaining and maintaining their DEA licenses, adhering to all regulatory requirements.
- Profile Maintenance: Keep provider profiles updated with the latest information, including changes in licenses, certifications, and contact details.
- Billing Support: Ensure that accurate and complete provider information is available for billing purposes, contributing to efficient revenue cycle management.
- Communication: Maintain regular communication with providers, insurance payers, and internal stakeholders to address any credentialing-related inquiries or issues.
- Documentation: Document all credentialing activities and maintain organized records for audit and compliance purposes.
Qualifications:
- A minimum of two years of successful credentialing experience is required.
- Strong understanding of licensing and certification requirements for medical providers and clinics.
- Familiarity with the credentialing process for pain management specialists and other healthcare professionals.
- Excellent organizational skills and attention to detail.
- Strong communication and interpersonal skills, both verbal and written.
- Ability to work independently and manage multiple tasks effectively.
- Proficiency in using credentialing software and electronic health records systems.
- A reliable internet connection and a dedicated workspace for remote work.
- Advanced English level
- 40 hours, Flexible work schedule with Monday to Friday business hours.
- Opportunity to work remotely from the Philippines.
