[Hiring] Credentialing Coordinator @Penbrothers

Role Description

This role supports the Credentialing Coordinator, internal departments, and insurance payors. The primary focus is on application preparation, provider credential verifications, and record-keeping database maintenance (including monitoring renewals in CredentialStream) to ensure all providers meet payor and compliance requirements accurately and on time.

• Credentialing Coordination: Support the initial and re-credentialing lifecycle, prepare applications for initial credentialing/demographic updates, and act as a daily liaison between specialists, payors, and internal teams.
• Process Ownership: Own the re-credentialing process for facilities and providers, maintain up-to-date CAQH profiles, verify provider directories, and serve as the main contact for the Revenue Cycle Management (RCM) team to resolve credentialing issues.
• Compliance & Regulation: Ensure all activities meet state/federal regulations and payor requirements, monitor industry policy changes, and resolve application deficiencies to prevent enrollment delays.
• Documentation & Data Management: Input and manage provider data (licenses, DEA certifications, malpractice insurance) within CredentialStream to ensure data integrity.
• Communication: Bridge communication between specialists and payors to speed up approvals, and guide healthcare providers through requirements and timelines.

Qualifications

• 1–2 years of experience in healthcare credentialing, provider enrollment, or a related healthcare administrative role.
• Experience in a dental practice, ambulatory surgery center (ASC), or medical group is highly preferred.
• Familiarity with CredentialStream, CAQH, and standard office tools (Microsoft Office/Google Workspace) is preferred.
• A strong working knowledge of insurance credentialing and payor enrollment processes.
• High attention to detail and strong time-management skills to handle concurrent deadlines.
• Professional communication and a proactive approach to problem-solving.

Requirements

• Experience in healthcare credentialing or related administrative roles.
• Knowledge of CredentialStream and CAQH.
• Strong attention to detail and time-management skills.
• Effective communication skills.

Benefits

• Meaningful work & Growth: We take every opportunity to stretch ourselves and deliver an excellent client experience.
• Employee as our biggest asset: We are genuinely invested in our people’s career and welfare.
• Global reach & local impact: Get to work with high-growth startups and dynamic companies from the comfort of your own home.
• Powering global startups: We’ve created 1,400 Filipino jobs that empower global start-ups to focus on growth.