About this role
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:
Process initial credentialing, recredentialing, and payer enrollment applications for healthcare facilities and providersCoordinate with insurance companies, managed care organizations, Medicare, Medicaid, and commercial payers regarding credentialing requirements and application statusMaintain accurate provider and facility records within credentialing databases and tracking systemsGather, verify, and organize required credentialing documentation such as licenses, certifications, malpractice insurance, W-9s, NPIs, and CAQH profilesConduct regular follow-up with payers to ensure timely processing and approval of applicationsMonitor credentialing expiration dates and support timely renewals and revalidationsUpdate and maintain CAQH profiles and payer portalsReview applications for completeness and accuracy prior to submissionCommunicate credentialing status updates to internal stakeholders and clientsAssist in resolving credentialing-related issues, denials, or discrepanciesEnsure compliance with payer requirements, company policies, HIPAA regulations, and credentialing standardsGenerate reports and maintain credentialing trackers as neededRequirements
At least 1 year of experience in US healthcare credentialing, provider enrollment, or insurance verificationExperience handling facility credentialing and payer enrollment processes preferredFamiliarity with Medicare, Medicaid, commercial insurance payers, and MCO credentialing processesKnowledge of CAQH, NPI, PECOS, and payer portals preferredStrong attention to detail and organizational skillsExcellent written and verbal communication skillsAbility to manage multiple applications and deadlines simultaneouslyProficient in Microsoft Office tools, particularly Excel and OutlookMust be willing to work on-site in Shaw Blvd, MandaluyongAmenable working night shiftsBenefits
What Can We Offer You?
Competitive salary and benefitsHealth Insurance with free dependents*10%-night differentialAttendance BonusPaid Time OffConvertible to cash leave creditsPerformance AppraisalWork-life balanceA focus on growing your career path with usWe encourage you to follow your passions and learn new skills
Our Commitment to You
Strong culture and values-driven leadershipWe create opportunities for you to learn and grow at any stage of your careerContinuous learning and innovationWe foster an all-inclusive environment where everyone thrives