Credentialing Specialist (US Healthcare) | Get a 21K Signing Bonus

ISTA Solutions, an outsourcing/offshoring company, is in search of an experienced Healthcare Customer Service Representative to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals, who prioritize employee satisfaction and work-life balance. At ISTA Solutions, we pride ourselves on creating a culture focused on long-term success and life-long learning. We're looking for a team player who is ready to contribute to our mission, just like you!

Account specific roles and responsibilities:

• Process initial credentialing, recredentialing, and payer enrollment applications for healthcare facilities and providers
• Coordinate with insurance companies, managed care organizations, Medicare, Medicaid, and commercial payers regarding credentialing requirements and application status
• Maintain accurate provider and facility records within credentialing databases and tracking systems
• Gather, verify, and organize required credentialing documentation such as licenses, certifications, malpractice insurance, W-9s, NPIs, and CAQH profiles
• Conduct regular follow-up with payers to ensure timely processing and approval of applications
• Monitor credentialing expiration dates and support timely renewals and revalidations
• Update and maintain CAQH profiles and payer portals
• Review applications for completeness and accuracy prior to submission
• Communicate credentialing status updates to internal stakeholders and clients
• Assist in resolving credentialing-related issues, denials, or discrepancies
• Ensure compliance with payer requirements, company policies, HIPAA regulations, and credentialing standards
• Generate reports and maintain credentialing trackers as needed

Requirements:
• At least 1 year of experience in US healthcare credentialing, provider enrollment, or insurance verification
• Experience handling facility credentialing and payer enrollment processes preferred
• Familiarity with Medicare, Medicaid, commercial insurance payers, and MCO credentialing processes
• Knowledge of CAQH, NPI, PECOS, and payer portals preferred
• Strong attention to detail and organizational skills
• Excellent written and verbal communication skills
• Ability to manage multiple applications and deadlines simultaneously
• Proficient in Microsoft Office tools, particularly Excel and Outlook

• Must be willing to work on-site in Shaw Blvd, Mandaluyong
• Amenable working night shifts

Benefits:
What Can We Offer You?

• Competitive salary and benefits
• Health Insurance with free dependents*
• 10%-night differential
• Attendance Bonus
• Paid Time Off
• Convertible to cash leave credits
• Performance Appraisal
• Work-life balance
• A focus on growing your career path with us
• We encourage you to follow your passions and learn new skills

Our Commitment to You

• Strong culture and values-driven leadership
• We create opportunities for you to learn and grow at any stage of your career
• Continuous learning and innovation
• We foster an all-inclusive environment where everyone thrives