Credentialing Specialist
New
A
Alpaca HealthHealthcare Technology
Must be based in the Philippines, United States East Coast (ET) hoursFull-TimeMiddle
Salary not disclosed
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Job Details
- Required Skills
- MS OfficeGoogle WorkspaceData entry
Requirements
- Bachelor’s degree or equivalent experience
- Previous experience in healthcare credentialing, provider enrollment, medical billing, or healthcare operations preferred
- Understanding of provider credentialing and payer enrollment processes
- Attention to detail and strong organizational skills
- Strong written and verbal communication skills
- Strong problem-solving and follow-through abilities
- Proficiency in MS Office and Google Workspace
- Comfortable working with spreadsheets, databases, and multiple web-based payer portals
- Ability to manage multiple priorities and meet deadlines in a fast-paced environment
- Ability to work independently and remotely
- Ability to work United States East Coast (ET) hours
- Must be based in the Philippines
Responsibilities
- Manage provider credentialing and enrollment applications with commercial and government health plans
- Submit, track, and follow up on provider credentialing and payer enrollment applications
- Maintain accurate provider and enrollment information across internal systems and payer portals
- Monitor application statuses, identify missing information or documentation, and resolve enrollment issues
- Communicate with payers and providers to obtain required documentation and resolve credentialing discrepancies
- Conduct regular follow-ups with payers to ensure applications are progressing within expected timelines
- Research payer requirements, participation rules, and enrollment processes
- Keep detailed records of credentialing activity, effective dates, and payer communications
- Escalate complex credentialing or enrollment issues when needed
- Support the Credentialing team with special projects and process improvements
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