Credentialing Supervisor - Philippines - SYSGEN RPO

    SYSGEN RPO
    SYSGEN RPO Philippines

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    Pangkalusugan
    Paglalarawan

    Position: Credentialing Supervisor (100% Remote)

    Shift Schedule: Graveyard Shift / MST Hours

    Position Purpose

    The Credentialing Supervisor is responsible for leading and overseeing provider credentialing, recredentialing, payer enrollment, and privileging activities for physicians and advanced practice providers. This role combines hands-on credentialing expertise with supervisory responsibility, quality oversight, reporting, and process improvement.

    Key Responsibilities

    • Oversee and perform provider credentialing, re-credentialing, payer enrollment, and facility privileging
    • Ensure accuracy and completeness of applications (DEA, licensure, CAQH, PECOS, payer portals)
    • Conduct and oversee primary source verification activities
    • Track credentialing work queues, turnaround times, and accuracy metrics
    • Perform quality audits and escalate risks or delays
    • Produce weekly status and performance reports
    • Provide guidance and informal coaching to credentialing staff
    • Serve as a subject matter expert for complex cases and special projects
    • Lead process improvement and automation initiatives

    Education & Experience

    • High School Diploma required; Bachelor's degree preferred
    • 3–5+ years of U.S. healthcare credentialing or payer enrollment experience
    • CPCS or CPES certification strongly preferred
    • Experience with PECOS, CAQH, and credentialing platforms preferred

    Work Environment

    • Remote position (Philippines-based)
    • Requires reliable high-speed internet
    • HIPAA-compliant handling of sensitive data
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