Credentialing Specialist (US Healthcare)

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

• Coordinate and manage the credentialing process for healthcare providers and facilities with payers, health plans, and other organizations.
• Ensure timely submission, tracking, and follow-up of all credentialing applications and re-credentialing efforts.
• Maintain accurate and complete provider records in internal databases and payer portals.
• Interpret and apply payer requirements and federal/state regulations to ensure compliance.
• Liaise with providers, internal teams, and external payer contacts to resolve credentialing issues and ensure smooth onboarding.
• Monitor expiration dates for licenses, certifications, and insurance, and initiate timely renewals.
• Assist in the execution and maintenance of provider contracts and agreements.

• At least 6 months BPO experience in a Healthcare Account, specifically handled Credentialing
• Good working knowledge with US Healthcare Insurance (Medicare, Medicaid, etc)
• Familiar with MS Tools (Word, Excel, Outlook)

• Excellent verbal and written English skills
• Must be willing to work on-site in Mandaluyong
• Amenable working night shifts

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