Credentialing Coordinator

 About Penbrothers 

Penbrothers is an HR & remote talent management partner and one of the fastest-growing companies in the Philippines. We provide talented Filipinos with global opportunities in high-growth startups and dynamic companies, from the comfort of their own homes.

About the Client

Our client is a multi-state ambulatory surgery center specializing in pediatric and special needs dentistry under general anesthesia. Their mission is to provide safe, compassionate, and efficient surgical care while creating a supportive environment for patients, families, and staff. To ensure quality care and regulatory compliance, we are seeking a detail-oriented Credentialing Specialist to join their growing team.

About the Role

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. 

What you’ll do

• 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.

 

What You Bring

• Experience: 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.

• System Knowledge: Familiarity with CredentialStream, CAQH, and standard office tools (Microsoft Office/Google Workspace) is preferred.

• Key Skills: A strong working knowledge of insurance credentialing and payor enrollment processes. High attention to detail, strong time-management skills to handle concurrent deadlines, professional communication, and a proactive approach to problem-solving

 Our Hiring Process

We utilize AI tools to enhance hiring efficiency and ensure a fair evaluation. Consequently, candidates will engage with an AI Interviewer, supervised by Human Talent Acquisition Experts who will support your entire application journey.

Our AI Expectations: While we encourage you to use AI for CV refinement and research, we require that all interviews and assessments be completed through your own authentic effort. The use of real-time AI assistance during interviews or to complete skills tests is strictly prohibited to ensure a fair and genuine evaluation of your capabilities.

What You’ll Get

At Penbrothers, we are obsessed with creating positive employee experiences. Here you’ll find an environment that nurtures learning and provides opportunities for growth. You’ll have the opportunity to make an impact on fast-growing startups and dynamic companies. 

·   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.