Credentialing Specialist
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Job Description
Credentialing Specialist managing provider enrollment for Alpaca Health, which helps clinicians launch autism-care clinics. Tracking payer applications and resolving credentialing issues remotely from 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
Requirements:
- 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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