Overview
Credentialing Specialist (US Healthcare) GDD Jobs in Mandaluyong, National Capital Region, Philippines at ISTA Solutions
Title: Credentialing Specialist (US Healthcare) GDD
Company: ISTA Solutions
Location: Mandaluyong, National Capital Region, Philippines
ISTA Solutions, an outsourcing/offshoring company, is in search of an experienced Healthcare Customer Service Representative to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals, who prioritize employee satisfaction and work-life balance. At ISTA Solutions, we pride ourselves on creating a culture focused on long-term success and life-long learning. We’re looking for a team player who is ready to contribute to our mission, just like you!
Account Specific Roles And Responsibilities
Coordinate and manage the credentialing process for healthcare providers and facilities with payers, health plans, and other organizations.
Ensure timely submission, tracking, and follow-up of all credentialing applications and re-credentialing efforts.
Maintain accurate and complete provider records in internal databases and payer portals.
Interpret and apply payer requirements and federal/state regulations to ensure compliance.
Liaise with providers, internal teams, and external payer contacts to resolve credentialing issues and ensure smooth onboarding.
Monitor expiration dates for licenses, certifications, and insurance, and initiate timely renewals.
Assist in the execution and maintenance of provider contracts and agreements.
Requirements
At least 6 months of experience in credentialing or provider enrollment (US Healthcare)
Good working knowledge with US Healthcare Insurance (Medicare, Medicaid, etc)
Familiar with MS Tools (Word, Excel, Outlook)
Excellent verbal and written English skills
Must be willing to work on-site in Mandaluyong
Amenable working night shifts
Benefits
What can we offer you?
Competitive salary and benefits
Health Insurance with free dependents*
10%-night differential
Attendance Bonus
Paid time off
Convertible to cash leave credits
Performance Appraisal
Work-life balance
A focus on growing your career path with us
We encourage you to follow your passions and learn new skills
Our commitment to you
Strong culture and values-driven leadership
We create opportunities for you to learn and grow at any stage of your career
Continuous learning and innovation
We foster an all inclusive environment where everyone thrives
