Virtual Healthcare Assistant and Credentialing Specialist experienced in U.S. insurance enrollment, follow-ups, and recredentialing for all major healthcare payers. Highly familiar with CAQH and Availity re-attestation processes. Skilled in insurance verification, including eligibility and benefits checks and updating patient coordination of benefits (COB). Also provides reliable administrative support such as scheduling, data entry, and document management. Detail-oriented, HIPAA-compliant, and efficient in supporting healthcare operations.
Experience: 6 months - 1 year
Credentialing Specialist responsible for enrolling healthcare providers with affiliated U.S. insurance plans through payer portals, email submissions, and roster submissions. Maintains and updates provider records in CAQH and Availity, ensuring accurate licensure, DEA, CDS, board certifications, professional liability insurance, personal information, and credentialing contacts.
Experience: 1 - 2 years
Responsible for verifying patients' healthcare insurance and ensuring coordination of benefits is accurate and up to date, including the review of backdated insurance lapses to ensure claims are reprocessed and paid accordingly. Evaluates restrictions, eligibility, and benefits across U.S. healthcare insurance plans to determine whether coverage should be added to the patient's date of service.
Experience: 2 - 5 years
Assists healthcare providers with inquiries related to patients' healthcare insurance, including eligibility and benefits verification and prior authorization requirements, when applicable, by providing timely and efficient support via phone communication.
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