Healthcare Credentialing Specialist

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Imagenet LLC

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

📦 Logistics

📣 Marketing

💰 Private Equity Round on 2022-12

Healthcare • Logistics • Marketing

Imagenet LLC is a leading provider of business continuity services for healthcare organizations, specializing in digital mailroom solutions, claims adjudication, contact center operations, and workflow management. With over two decades of experience and a reputation for enhancing efficiency and accuracy, Imagenet partners with health plans to streamline processes and improve member satisfaction. Their services are designed to reduce claims turnaround times, increase processing capacities, and lower contact center wait times. By integrating scalable solutions tailored to specific needs, Imagenet enables healthcare organizations to accelerate productivity and mitigate operational challenges.

📋 Description

• Coordinate, manage, and maintain credentialing services for healthcare providers and practices • Establish and maintain credentialing relationships with payers and provider networks • Assist providers in preparing, processing, submitting, and monitoring paper and electronic credentialing applications and supporting documentation • Monitor credentialing database documents and data for quality, accuracy, and timely completion • Coordinate provider enrollment according to individual payer requirements • Organize, label, maintain, and securely store credentialing forms, applications, and supporting documentation • Prepare, review, and submit credentialing and recredentialing applications to payers and provider networks • Monitor applications and follow up with providers and payers to ensure timely completion • Train providers and office staff on credentialing applications and services • Communicate with providers, payers, and internal stakeholders via phone, email, and chat • Create, edit, and maintain credentialing documents, correspondence, and supporting materials • Maintain accurate records throughout the credentialing lifecycle • Comply with federal, state, accreditation, client, and company policies and procedures • Meet departmental productivity, quality, attendance, and service-level expectations • Protect confidential provider and patient information and follow information-security protocols • Report security concerns or suspicious activities

🎯 Requirements

• At least 2 years of BPO healthcare experience involving provider credentialing • Provider credentialing experience and familiarity with industry-recognized credentialing standards • Previous call center/BPO experience • Proficiency in Microsoft Office applications: Word, Excel, Outlook, and PowerPoint • Proficiency in internet-based applications and online systems • Working knowledge of Adobe Acrobat PDF • Working knowledge of healthcare terminology, eligibility, benefits, medical and dental claims, and payer processes • Working knowledge of technical and procedural aspects of provider credentialing • Excellent analytical, organizational, and time-management skills • Strong attention to detail and accuracy • Excellent written, verbal, and interpersonal communication skills • Strong copywriting and business-writing skills • Ability to communicate professionally by phone, email, and chat • Ability to handle confidential information with tact and discretion • Ability to manage multiple projects and provider accounts simultaneously • Ability to prioritize work in a fast-paced environment while maintaining accuracy • Ability to solve practical problems and make sound decisions • Self-motivated, adaptable, resourceful, and able to work independently with minimal supervision • Willingness to work shifting schedules, graveyard shifts, holidays, and weekends when required • Candidate residing in Metro Manila or nearby provinces is preferred • Stable internet connection of at least 35 Mbps • Dedicated workspace suitable for remote work • Can start ASAP

🏖️ Benefits

• Work from Home • Company-provided equipment • 13th Month Pay • Internet Allowance • HMO (Medical and Dental Coverage)