Credentialing and Administrative Specialist
New
W
Wider CircleHealthcare
100% Remote — work from anywhere in the PhilippinesFull-TimeMiddle
Salary5 - 7 USD per hour
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Job Details
- Languages
- English
- Experience
- 1–3 years
- Required Skills
- Data entryCRMGoogle WorkspaceSlack
Requirements
- 1–3 years of administrative support experience, ideally within a US healthcare setting.
- Experience with US healthcare credentialing processes, including primary source verification and payer enrollment.
- Strong organizational skills with a methodical approach to documentation, data entry, and workflows.
- Strong written English communication skills.
- Proficiency with Google Suite, Slack, and CRM or support software.
- Based in the Philippines with a reliable remote work setup.
- Proactive, problem-solving mindset and comfort navigating ambiguity.
Responsibilities
- Report directly to the RCM Manager, ensuring all credentialing activities align tightly with billing and revenue cycle requirements.
- Manage the end-to-end credentialing and re-credentialing process across Medicare, Medicaid, and private insurance networks.
- Conduct primary source verification and maintain credentialing databases with high accuracy and attention to detail.
- Coordinate with licensing boards, payers, and internal teams to process applications and resolve inquiries.
- Support backend documentation and privileging processes for new provider onboarding to ensure a seamless transition.
- Ensure strict adherence to all relevant federal, state, and local regulations and accreditation standards.
- Proactively identify and help the RCM team resolve credentialing discrepancies, generating reports and refining administrative workflows during the pilot phase.
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