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Contracting and Credentialing Specialist - Philippines

extra holidays

Remote:

Full Remote

Contract:

Freelance

Work from:

Philippines

Offer summary

Qualifications:

Bachelor's degree in healthcare administration or related field, Strong knowledge of payor reimbursement methodologies, Excellent understanding of contracting and credentialing processes, Detail-oriented with excellent organizational skills.

Key responsabilities:

Provide expert knowledge on group contracting and credentialing
Verify qualifications of healthcare providers and maintain records

Forta Healthtech: Health + Technology Scaleup http://www.fortahealth.com/

51 - 200 Employees

See all jobs

Job description

FORTA’S MISSION:

Forta is clearing the path to quality healthcare by delivering the best possible outcomes with the utmost convenience. 1 in 36 children [CDC, 2023] is diagnosed to be on the autism spectrum. Currently, autism support via Applied Behavior Analysis (ABA) is difficult to access and the delivery model must be expanded to provide earlier access to families.

Forta is not only providing ABA services to our clients, but we’re also improving the future of the ABA experience for families by creating software and predictive algorithms that elevate clinicians to work smarter by surfacing the latest and most relevant case data. We are working diligently to continuously improve the patient journey and deliver personalized care by applying smart technology and investing in the growth of our world-class team.

Responsibilities:

Provide expert knowledge and advice on group contracting and provider credentialing processes, regulations, and best practices

Verify the qualifications of healthcare providers, ensuring all necessary documents are current, accurate, and compliant with industry standards

Collect, process, and maintain accurate records of contracts and credentials in accordance with regulatory requirements and company policies

Utilize internal credentialing database to track the status of credentialing applications, re-credentialing, and ongoing monitoring of credentials

Stay up-to-date with industry trends, changes in regulations, and emerging issues related to contracting and credentialing

Serve as a liaison between providers, internal departments, and insurance companies, addressing inquiries, and coordinating necessary documentation

Requirements:

Bachelor's degree in healthcare administration, business, or a related field

Strong knowledge of payor reimbursement methodologies, contract negotiation strategies, and industry regulations

Excellent understanding of contracting and credentialing processes, including provider enrollment, privileging, and payor landscape

Excellent communication and interpersonal skills, both written and verbal, with the ability to articulate complex concepts to diverse audiences

Strong interpersonal skills and the ability to collaborate effectively with cross-functional teams.

Detail-oriented with excellent organizational and time management skills.

Ability to maintain confidentiality and manage sensitive information

Ability to work independently and handle multiple projects simultaneously.

Apply Today!

We are looking for you! A driven, innovative, client-focused individual to join our team as we innovate the care and tools available to neuro-diverse families. If this position sounds like the opportunity you have been searching for, we want to speak with you!

We look forward to working with you!

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All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. Forta is a Drug-Free Workplace/ EO employer – M/F/Veteran/Disability.