• The Specialist II, Credentialing helps guide advanced placement newly entering their experiential learning course learners through their final credentialing needs to help support learners in the successful completion of the Experiential Learning (EL)program. • The incumbent will provide guidance on navigating credentialing systems, and be a key point of contact regarding credentialing needs for Direct Focused Care (DFC). • Provides exceptional customer service to a larger group learners while helping to navigate the College Catalog, credentialing systems, requirements from the Center of Disease Control (CDC), purchase and completion of background checks and drug screens, and build transparency and understanding of expectations during the completion of the program. • Collaborates cross-functionally to facilitate the onboarding of credentialing for new admission to the College. • Guides learners in creating their profile within the credentialing portals. • Contacts learners to assist in maintaining and restoring credentialing compliance. • Reviews compliance in multiple systems to complete audits and determine appropriate contact and action. • Participates in additional training and compliance activities to promote additional learning and understanding of credentialing processes and policies. • Provides guidance to fellow collaborators and learners on policies, procedures, and the requirements for experiential learning courses to attend their on-ground experience. • Participates in the successful implementation of other functional projects as they arise.

• 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