Credentialing And Provider Enrollment Specialist

Neolytix LLC

Philippines
On-site
Healthcare provider credentialing process
Primary source verification
Regulatory compliance
This role is responsible for directing and managing the end-to-end healthcare provider credentialing process to ensure full regulatory compliance and data integrity

Job Summary

  • This role is responsible for directing and managing the end-to-end healthcare provider credentialing process to ensure full regulatory compliance and data integrity.
  • You will oversee primary source verification, maintain meticulous documentation for licenses and certifications, and ensure all provider records adhere to CMS, HIPAA, and payer-specific standards.
  • The ideal candidate will be a detail-oriented professional capable of managing complex databases and supporting internal and external audits to maintain a high standard of organizational oversight.

Matching Summary

This role is responsible for directing and managing the end-to-end healthcare provider credentialing process to ensure full regulatory compliance and data integrity.

Skills & Requirements

Must-have

  • Healthcare provider credentialing process
  • Primary source verification
  • Regulatory compliance
  • Data management and record keeping
  • Proficiency with credentialing software

Nice-to-have

  • Detail-oriented professional
  • Managing complex databases
  • Supporting internal and external audits
  • High standard of organizational oversight

Key Requirements

  • 2+ years leadership experience
  • NCQA credentialing standards experience
  • NCQA surveys or health plan audits experience
  • Strong policy and procedure writing skills
  • Excellent English communication skills

Work Rights

Not specified

Tailored Resume

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