Medical Virtual Assistant, Credentialing
Posted 1 hour ago
You'll apply on the company's website.
About the Role
The organization is searching for a committed Medical Virtual Assistant focused on provider enrollment and credentialing. This position offers remote work opportunities based in the Philippines and necessitates availability during US business hours. You will support healthcare practices by enhancing operational efficiency and administrative performance. You will contribute to the team by ensuring precise medical documentation and facilitating consistent participation in insurance networks within a secure, managed professional environment.
Requirements
- Demonstrated background as a Provider Enrollment or Credentialing Specialist within the US healthcare sector.
- Practical experience managing Medicare revalidations and enrollments via the PECOS platform.
- Proficiency with CMS I&A, NPPES, and CAQH ProView tools.
- Proven capability in handling commercial payer credentialing and a minimum of one state-level Medicaid enrollment.
- High level of proficiency in both written and verbal English communication.
- Strong attention to detail to prevent processing delays caused by inaccuracies.
- Requirement for a dependable home-based workspace, including a quiet environment, a reliable main internet connection, and a secondary backup connection.
- Strong organizational habits and the persistence required to engage with US-based insurance payers for effective follow-ups.
Responsibilities
- Oversee the complete credentialing process for healthcare providers.
- Prepare, file, and monitor Medicare enrollments through PECOS, covering new enrollments, revalidations, reassignment requests, and changes to practice addresses.
- Maintain NPPES data, verifying the precision of taxonomy codes and NPI details, while managing CMS Identity and Access system connectivity.
- Dedicate substantial effort to processing state Medicaid enrollments and commercial insurance contracting applications.
- Manage CAQH ProView profiles by creating, editing, and re-attesting information while granting necessary payer access.
- Maintain constant communication with insurance carriers through portals, email, or telephone until final approval is obtained.
- Log effective dates and organize provider files alongside credentialing tracking documents.
- Monitor expiration dates for essential credentials, such as malpractice policies, board certifications, DEA registrations, and professional licenses, to coordinate timely renewals.
- Process documentation for hospital privileging.
- Aid billing departments in troubleshooting claim rejections tied to enrollment status.
- Ensure all tasks and processes comply with HIPAA standards.
Note: This listing is summarized and paraphrased by WorkNow from a publicly posted role. For the original wording and full details, please refer to the employer's official posting.
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