Medical Virtual Assistant (Credentialing)

PLEASE NOTE: This job is open to applicants in the Philippines only.

Full-time, 30 to 40 Hours/Week (US business hours)

Salary: $6/Hour

Job Title: Medical Virtual Assistant (Credentialing)

We are hiring a Medical Virtual Assistant with hands-on credentialing experience. You will own provider enrollment and credentialing from start to finish: Medicare enrollment through PECOS, commercial payer applications, CAQH upkeep and re-credentialing deadlines. This role is for an experienced credentialing specialist. It is not an entry-level Medical VA role.

Responsibilities:

• Prepare, submit and track Medicare enrollments in PECOS: initial enrollments, revalidations, reassignments (CMS-855I, 855B, 855R), changes of information and practice location updates.
• Manage NPPES records: apply for and update NPIs (Type 1 and Type 2), and keep taxonomy codes and addresses accurate.
• Manage CMS Identity & Access (I&A) connections and surrogacy so providers and staff have the right PECOS access.
• Complete commercial payer credentialing and contracting applications (e.g., UnitedHealthcare, Aetna, Cigna, BCBS, Humana) and state Medicaid enrollments.
• Create, update and re-attest CAQH ProView profiles, and authorize payer access.
• Follow up with payers by phone, email and portal until each application is approved, then record effective dates and provider IDs.
• Track licenses, DEA, board certifications, malpractice insurance and other expiring documents, and start renewals and re-credentialing before deadlines.
• Keep a credentialing tracker and provider files current, and send regular status reports to the client.
• Handle hospital privileging and facility credentialing paperwork when needed.
• Work with billing teams to resolve enrollment-related claim denials.
• Protect provider and patient information and follow HIPAA rules at all times.

Requirements

• Experience as a Credentialing Specialist or Provider Enrollment Specialist for US healthcare providers.
• Hands-on PECOS experience: you have submitted Medicare enrollments and revalidations yourself.
• Working knowledge of CAQH ProView, NPPES and CMS I&A.
• Experience with commercial payer credentialing and at least one state Medicaid enrollment.
• Strong attention to detail. One wrong date or missing document can delay an approval by weeks.
• Organized, persistent follow-up habits, with comfort calling US payers.
• Excellent written and spoken English.
• Reliable home office setup: a stable internet connection, a backup connection and a quiet workspace.
• Willing to work US business hours.

Originally posted on Himalayas