Medical Virtual Assistant, Credentialing

Job not on LinkedIn

🔥 1 minute ago

🇵🇭 Philippines – Remote

💵 $6 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👨‍💼 Executive Assistant

👻 Ghost score 0%

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📋 Description

• Prepare, submit and track Medicare enrollments in PECOS: initial enrollments, revalidations, reassignments (CMS-855I, 855B, 855R), changes of information and practice location updates. • Manage NPPES records: apply for and update NPIs (Type 1 and Type 2), and keep taxonomy codes and addresses accurate. • Manage CMS Identity & Access (I&A) connections and surrogacy so providers and staff have the right PECOS access. • Complete commercial payer credentialing and contracting applications (e.g., UnitedHealthcare, Aetna, Cigna, BCBS, Humana) and state Medicaid enrollments. • Create, update and re-attest CAQH ProView profiles, and authorize payer access. • Follow up with payers by phone, email and portal until each application is approved, then record effective dates and provider IDs. • Track licenses, DEA, board certifications, malpractice insurance and other expiring documents, and start renewals and re-credentialing before deadlines. • Keep a credentialing tracker and provider files current, and send regular status reports to the client. • Handle hospital privileging and facility credentialing paperwork when needed. • Work with billing teams to resolve enrollment-related claim denials. • Protect provider and patient information and follow HIPAA rules at all times.

🎯 Requirements

• Experience as a Credentialing Specialist or Provider Enrollment Specialist for US healthcare providers. • Hands-on PECOS experience: you have submitted Medicare enrollments and revalidations yourself. • Working knowledge of CAQH ProView, NPPES and CMS I&A. • Experience with commercial payer credentialing and at least one state Medicaid enrollment. • Strong attention to detail. One wrong date or missing document can delay an approval by weeks. • Organized, persistent follow-up habits, with comfort calling US payers. • Excellent written and spoken English. • Reliable home office setup: a stable internet connection, a backup connection and a quiet workspace. • Willing to work US business hours.

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