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