Credentialing Specialist

 Posted an hour ago
     
2-5 years experience
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AI Summary

Manage provider credentialing and enrollment applications with commercial and government health plans. Maintain accurate provider information across internal systems and monitor application statuses to ensure timely progress.

📌 About Alpaca Health

Alpaca Health enables clinicians to become entrepreneurs, starting in autism care.

We help clinicians launch and scale their own clinics by providing AI-powered software, payer contracting, and full back-office infrastructure. Our goal is simple: shift power in healthcare away from large consolidated entities and back to clinicians.

This is a fully remote, Philippines-based position. We’re looking for candidates located in the Philippines who are able to work United States East Coast (ET) hours.

🚧 What You’ll Do

  • 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

🧠 Who You Are

  • Bachelor’s degree or equivalent experience

  • Previous experience in healthcare credentialing, provider enrollment, medical billing, healthcare operations, or a related field preferred

  • Strong understanding of provider credentialing and payer enrollment processes preferred

  • Excellent attention to detail and organizational skills

  • Strong written and verbal communication skills

  • Strong problem-solving and follow-through abilities

  • Proficient in MS Office, Google Workspace, and business systems

  • Comfortable working with spreadsheets, databases, and multiple web-based payer portals

  • Ability to manage multiple priorities and meet deadlines in a fast-paced, remote environment

  • Self-motivated, dependable, and comfortable working independently

  • Willing and able to work United States East Coast (ET) hours

  • Must be based in the Philippines

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