• Complete enrollment/credentialing and re-credentialing applications • Maintain a detailed log of all pending and completed work • Communicate the results and status of the applications to physicians, payers, managers, and co-workers. • Maintenance of physician enrollment and CAQH profiles • Documentation within enrollment database • Coordinate signatures • Payer processing and research • Involves extensive phone work and internet. • Research and resolve claim issues related to physician enrollment. • Other tasks as needed.

• Perform manual license and certification lookups through state boards, professional licensing bodies, and other approved verification sources. • Verify information such as full name, date of birth, license number, certification status, expiration dates, and other relevant credential details. • Review assigned tickets, tasks, or lookup requests and process them according to client-defined workflows. • Capture screenshots or other approved documentation as evidence of license or certification verification. • Upload verification results and supporting documentation into the client’s platform or system. • Ensure all information entered into the system is accurate, complete, and aligned with client requirements. • Identify and escalate incomplete, inconsistent, expired, unverifiable, or questionable credential records. • Follow strict confidentiality and data security protocols when handling PII and sensitive information. • Maintain productivity and turnaround time expectations based on assigned volume and client SLAs. • Communicate with internal supervisors or client points of contact for clarifications, exceptions, or process updates. • Support process improvements by identifying recurring issues, workflow gaps, or verification challenges.

Role Description We're looking for a detail-oriented Credentialing & License Verification Specialist to join our growing team. In this role, you'll be responsible for verifying professional licenses, certifications, and credentials through state licensing boards and other authorized verification sources, ensuring accurate and timely documentation for our clients. If you have a keen eye for detail, enjoy working with data, and take pride in maintaining accuracy and confidentiality, we'd love to hear from you. - Perform manual license and certification lookups through state boards, professional licensing bodies, and other approved verification sources. - Verify information such as full name, date of birth, license number, certification status, expiration dates, and other relevant credential details. - Review assigned tickets, tasks, or lookup requests and process them according to client-defined workflows. - Capture screenshots or other approved documentation as evidence of license or certification verification. - Upload verification results and supporting documentation into the client’s platform or system. - Ensure all information entered into the system is accurate, complete, and aligned with client requirements. - Identify and escalate incomplete, inconsistent, expired, unverifiable, or questionable credential records. - Follow strict confidentiality and data security protocols when handling PII and sensitive information. - Maintain productivity and turnaround time expectations based on assigned volume and client SLAs. - Communicate with internal supervisors or client points of contact for clarifications, exceptions, or process updates. - Support process improvements by identifying recurring issues, workflow gaps, or verification challenges. Qualifications - High school diploma or equivalent required. - Data privacy, HIPAA, compliance, or healthcare administration training is an advantage but not required. - Previous experience in credentialing, license verification, data verification, healthcare administration, back-office support, or a similar role. - Strong attention to detail and ability to accurately validate information across multiple sources. - Experience using online portals, databases, or public records for research and verification. - Ability to follow detailed workflows, standard operating procedures, and client-specific instructions. - Strong written English communication skills. - Comfortable handling sensitive personal information, including PII. - Ability to work independently with minimal supervision while maintaining accuracy and productivity. - Basic computer skills, including data entry, screenshot capture, file upload, and system navigation. Preferred Qualifications - Associate’s or Bachelor’s degree in Business Administration, Healthcare Administration, Information Management, or related field preferred. - Experience in healthcare credentialing or professional license verification. - Familiarity with U.S. state licensing boards, healthcare certifications, or regulatory verification processes. - Experience working with ticketing systems, CRM tools, workflow platforms, or credentialing platforms. - Prior BPO, healthcare back-office, compliance, or administrative support experience. - Familiarity with HIPAA, ISO, data privacy, or information security practices is an advantage. Benefits - HMO with 1 free dependent upon hire - Life Insurance - 10% Night Differential - 20 PTO credits annually - VL and SL cash conversion - Annual Performance-Based Merit Increases and Employee Recognition - Great Company Culture - Career Growth and Learning - WORK FROM HOME - NIGHT SHIFT - Php 37,000 to 41,500 all in

• Maintains accurate records of providers’ credentials. • Processes providers’ applications for privileges and reappointments and monitors licensure renewal activity for Physicians, CRNA’s, APRN’s, and PA’s. • Processes initial and reappointment assignments for hospitals and surgical centers and for assigned divisions. • Performs internal credentialing for all applicable USAP clinicians, as assigned. • Maintains complete file of provider’s licensure and credentials. • Monitors renewals of licensure and forwards copies of licensure to facilities as renewals are received. • Maintains and updates credentialing database, inclusive of demographic and licensure information. • Maintains and updates continuing medical education/ACLS credits and other training requirements. • Maintains and updates curriculum vitae/profiles for each provider. • Maintains correspondence files and credentialing archival files. • Performs other credentialing duties as requested. • Adheres to all company policies and procedures. • Performs other duties as assigned.