Job Opportunities in Philippines


October 10, 2024

MedRisk LLC

Mandaluyong

FULL TIME


Credentialing Special Level I

Position Summary

Maintaining a clean and updated database is crucial for the success of Med Risk. All business units rely on updated and valid information to ensure our providers and clients are receiving the services they come to expect. We also need to ensure we are compliant with the requirements to pass our internal and external audits. The Credentialing Specialist team has to work closely with our network providers to ensure we gather all necessary paperwork to credential a provider according to our contract with the providers.

Primary Duties & Responsibilities

  • Credentialing Specialist will review and screen Initial and Re-credentialing applications for completeness, accuracy, and compliance with federal, state, local and Med Risk regulations, guidelines, policies, and standards.
  • Credentialing Specialist will follow workflows for communication via Call, Email, and Fax with providers to gather credentialing documents.
  • Credentialing Specialist will review all received Credentialing documents and certifications to ensure accuracy and within good standing with appropriate state agencies.
  • Credentialing Specialist will review and update all external and internal provider request such as Adding and Removing Services, Locations, Therapists, and Change in Provider demographics.
  • Credentialing Specialist will maintain internal Provider system to ensure all information is accurate.
  • Credentialing Specialist will monitor provider accounts ensure completeness and accuracy; reviews all file documentation for compliance with quality standards, accreditation requirements, and all other relevant policies; prepares and provides information to internal and external customers as appropriate.
  • Other Duties Assigned.

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