Department: RCM - Philippines
Reports To: Head of RCM

The Credentialing Specialist plays a crucial role in ensuring all providers and clinics are credentialed promptly, maintaining up-to-date documentation, and ensuring all providers are current with licensures.

• Health Insurance/HMO
• Enjoy unlimited MadMax Coffee
• Diverse learning & growth opportunities
• Accessible Cloud HR platform (Sprout)
• Above standard leaves

• Demonstrate quality computer skills and a comprehensive command of essential Microsoft applications, including Outlook, Word, Excel, and Teams.
• Manage the entire insurance credentialing process for vision practices, ensuring compliance with all relevant regulations and guidelines.
• Maintain a comprehensive database of provider information, including licenses, certifications, and insurance documents.
• Verify the accuracy and completeness of all insurance applications and related documents.
• Communicate with insurance companies, payers, and other relevant organizations to resolve credentialing issues.
• Ensure timely submission of credentialing applications and follow up on the status of pending applications.
• Collaborate with vision practices, administrative staff, and external parties to gather necessary information for credentialing.
• Stay updated on industry regulations, changes, and trends related to insurance credentialing.
• Assist in developing and implementing strategies to improve the overall credentialing process.
• Prioritize and maintain strict confidentiality in all situations.
• Manage incoming and outgoing communications between multiple parties, meeting policy timelines, and updating the credentialing database; provide status reports and communicate provider and/or clinician participation information to internal and external customers.
• Possess critical thinking skills and navigate challenges with forethought and common sense to achieve successful outcomes.

• 2-3 years of experience in credentialing within a vision/medical office setting.
• Strong written and verbal English skills.
• Basic understanding of ICD-10 coding preferable.
• Proficiency with Microsoft Office and Adobe.
• Ability to work in a fast-paced environment.
• Attention to detail and ability to multitask effectively.
• Ability to work independently and as part of a team.
• Adheres to internal and system-wide

• Scanned copy of valid NBI Clearance
• Accomplished Medical or PEME Slip (covered by KMC)
• 2x2 & Half body picture with white background
• Proof of government numbers (TIN, SSS, Pag-ibig, & Philhealth)
• Photocopy of 2 valid IDs – front & back (government-issued)
• Clear copy of your Birth Certificate (PSA or NSO)
• Accomplished HR Forms & Promissory Note (will be provided by KMC’s Onboarding Team

If you're a rockstar at what you do and looking to be a part of our amazing story, we want to hear from you!

We offer attractive salaries and benefits plus you get to work in some of the Philippines' best flexible workspaces. Our employees also get to enjoy exclusive discounts, rewards and freebies, and invites to our monthly events. We are always recruiting for roles in IT & Development, Marketing, Business Administration, HR & Recruitment and Legal & Finance Roles.

KMC provides quality employment opportunities for job-seekers looking for a career that is both challenging and fulfilling. We are also committed to providing equal opportunities at every selection stage. We do not discriminate due to age, gender, sexual orientation, ethnicity, nationality, and religion.

KMC Solutions offers a variety of career opportunities in Metro Manila, Cebu and Clark & Iloilo. We are always looking for talented and enthusiastic individuals who are ready to make their next big career move.

At KMC, we foster an inclusive and positive workplace for all. We push our members to succeed in everything they do through our collaborative work environment. We encourage our community to work hard and reach their full potential while delivering results that matter for our members and you as professionals.

We host amazing and quality events and implement people-centric policies to work flexibly. We ensure that everyone in our expansive network is engaged, from our internal employees and those who work on behalf our offshore partners.

At KMC, we work hard and we are committed to putting our best foot forward in everything we do. Everyone is encouraged to be an individual while also working for the collective good of the KMC Community. We believe mistakes are opportunities and that you should not present a solution without a problem.

We also know when hard work deserves to be recognized so we reward our employees with monthly parties, free trips and much much more!