Global Credentialing Specialist

This is a fully remote position, open to applicants in Philippines.

📋 Description

• Review and assess credentialing, re-credentialing, and provider qualification files submitted to ComPsych against established criteria to determine eligibility and compliance within the network, adhering to designated timelines.

• Confirm provider credentials, licenses, certifications, education, and professional qualifications based on country-specific requirements and ComPsych standards.

• Conduct primary source verification and regulatory checks, as needed, to facilitate provider onboarding and ongoing participation in the network.

• Analyze international provider qualifications and supporting documentation to ensure consistency with company, client, and local market standards.

• Reach out to providers (via phone or email) to request any missing or incomplete information.

• Identify and forward “red flag” files for further examination and resolution.

• Execute necessary queries on designated providers, obtain written reports, and review for incidents within specified timelines.

• Adhere to performance targets, including processing initial applications and re-credentialing files (“red-reds”) daily.

• Accurately document notes and decisions in CPP (Credentialing Processing Platform) to support determinations on provider files.

• Maintain precise provider records and documentation within credentialing systems and databases, encompassing required data entry.

• Collaborate with internal stakeholders regarding provider eligibility, credentialing exceptions, and compliance requirements for global provider networks.

• Log into all necessary systems, including the call queue, on your assigned rotation day and throughout your work shift, ensuring timely call responses.

• Address all messages in the inbox on assigned rotation day to provide prompt responses to internal and external customers/providers.

• Elevate any concerns, client or customer issues, or delays to your Team Lead for assistance and resolution.

• Perform additional duties as assigned.

⛳️ Requirements

• A bachelor's degree is required.

• Experience in provider credentialing, licensing, compliance, or healthcare operations is required; experience in the mental health or broader healthcare industry is strongly preferred.

• Familiarity with international healthcare credentials, licensing requirements, or provider network operations is preferred.

• Capability to interpret and assess professional qualifications from diverse countries and regulatory frameworks.

• Strong multitasking abilities and excellent organizational skills.

• Keen attention to detail and follow-up skills.

• Self-motivated individual with the ability to multitask and work independently.

• Exceptional organizational and project management capabilities.

• Effective interpersonal and communication skills, with the ability to engage professionally across various cultures and time zones.

🏝️ Benefits

• Statutory paid leave and public holidays.

• Employer-sponsored health and social insurance contributions (where applicable).

• Employee wellbeing programs.

• Access to Employee Assistance Programs (EAP).