Credentialing Specialist

Job Title: Credentialing Specialist

Location:BGC, Taguig City
Schedule:Night Shift

When you join AGSI, you become part of a company that values strong partnerships, innovation, and growth—not just for our clients, but for our people too.

What’s in it for You?

We don’t just want you to succeed—we want you to thrive. At AGSI, you’ll enjoy:

• Attendance Incentives and Non-taxable Allowances, because your dedication deserves recognition.
• 30 Leave Credits per Year, giving you generous time off to recharge, travel, or spend with family.
• HMO Coverage for You and Your Dependents with access to counseling programs to support both health and wellbeing.
• Group Life Insurance for your peace of mind.
• Regular Work Schedule with Weekends Off, so you can enjoy balance and predictability.
• Great Company Culture with fun in-office activities, engaging team events, and meaningful CSR initiatives that let you give back to the community.
  
  

Here, you won’t just find a job. You’ll find a team that invests in your growth and celebrates your success.

About Our Client

Our client is a leading ophthalmology and eye care organization based in the United States, dedicated to providing comprehensive vision care through advanced medical, surgical, and optical services. Their experienced team of eye care professionals is committed to delivering exceptional patient outcomes by combining clinical excellence with compassionate, patient-centered care.

Serving patients across multiple locations, the organization offers a full spectrum of eye care services, including routine eye examinations, cataract surgery, glaucoma management, retina care, LASIK, and other specialized treatments. They continuously invest in innovative technology and streamlined operational processes to enhance the patient experience while maintaining the highest standards of quality and efficiency.

Joining this team means becoming part of a collaborative healthcare organization where accuracy, accountability, and operational excellence are essential to supporting high-quality patient care.

Job Summary

The Credentialer is responsible for managing the credentialing, recredentialing, and insurance enrollment process for healthcare providers. This role involves coordinating with providers, insurance companies, and other stakeholders to ensure accurate documentation, timely submissions, and compliance with payer requirements.

Key Responsibilities

• Manage initial credentialing, recredentialing, and provider enrollment with commercial and government insurance payers.
• Collect, verify, and maintain provider credentials, including licenses, certifications, NPI, CAQH, malpractice insurance, and other required documents.
• Complete and submit insurance enrollment and credentialing applications accurately and within required timelines.
• Monitor application status, follow up with insurance payers, and resolve missing information or enrollment issues.
• Communicate with providers and internal teams regarding credentialing requirements, documentation, and application status.
• Maintain accurate and up-to-date provider credentialing records and track expiration dates.
• Coordinate with insurance representatives and payer portals to obtain updates, approvals, and participation information.
• Ensure compliance with payer, regulatory, and organizational credentialing requirements.
• Prepare regular reports on credentialing status, pending applications, expirations, and outstanding requirements.
• Handle calls and email correspondence with providers, insurance companies, and other stakeholders as needed.

Preferred Qualifications

• Experience in healthcare credentialing, provider enrollment, medical billing, or healthcare administration.
• Familiarity with CAQH, NPI, PECOS, Medicare, Medicaid, and commercial insurance payers.
• Strong attention to detail and documentation skills.
• Excellent follow-up, organization, and communication skills.
• Comfortable making phone calls and coordinating with insurance representatives.
• Ability to manage multiple providers, applications, and deadlines simultaneously.