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Credentialing Coordinator

Role overview

Qualifications

  • 1–2 years of experience in healthcare credentialing, provider enrollment, or related healthcare administrative role.
  • Familiarity with CredentialStream, CAQH, and standard office tools (Microsoft Office/Google Workspace).
  • Strong working knowledge of insurance credentialing and payor enrollment processes.

Responsibilities

  • Support the initial and re-credentialing lifecycle, prepare applications for initial credentialing/demographic updates.
  • Own the re-credentialing process for facilities and providers, maintain up-to-date CAQH profiles.
  • Ensure all activities meet state/federal regulations and payor requirements, monitor industry policy changes.
  • Input and manage provider data (licenses, DEA certifications, malpractice insurance) within CredentialStream.

Key facts

Hard skills

Other skills

  • Detail Oriented
  • Time Management
  • Microsoft Office
  • Communication
  • Problem Solving

About the company

Penbrothers logo

Penbrothers

  • SME
  • 201–500
We are Penbrothers, your remote HR partner! We work with startups and SMEs worldwide, helping them build and scale their teams with talent in the Philippines at a fraction of the cost. With several offices in various locations, Penbrothers makes it easier for companies to focus on their core business by taking care of: - Talent Acquisition - Employment and Onboarding - HR Management and Payroll - Compliance - Office Space or Remote Enablement

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Job description

 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 & AI Disclaimer: We use AI tools to streamline our application process—including an initial conversation with an AI Interviewer. All hiring decisions are made entirely by humans: our Talent Acquisition team guides your full candidate journey and makes all evaluation decisions.

You are welcome to use AI for CV refinement and research, but real-time AI assistance during interviews or skill assessments is strictly prohibited to ensure an authentic evaluation. 

Read our full AI Disclaimer to learn more

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.

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