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Provider Validation Specialist

OpsArmy

Job Location:

Makati City - Philippines

Monthly Salary: Not provided by the employer

Posted: 9 October 2026 (11 hours ago)

Application Deadline: 6 January 2027

Vacancies: 1 Vacancy

Job Summary

Provider Validation Specialist

Job Type: Full-time
Work Setup: Remote
Schedule: Full-time; must have availability to overlap with U.S. Eastern Time (EST) business hours

Apply here: the Role

We are looking for a detail-oriented Provider Validation Specialist to support a medical records retrieval workflow.

In this role you will research healthcare providers and identify the appropriate custodians for different types of medical records and billing documents. You will verify submission requirements prepare accurate request information maintain provider data and resolve issues that may delay records requests.

The ideal candidate is highly organized comfortable conducting detailed research and able to work accurately with healthcare billing and provider information.

Key Responsibilities

Identify Record Custodians: Research healthcare providers and identify the appropriate custodian for each type of record including records departments billing offices physician groups radiology providers ambulance services and other third-party entities.
Verify Submission Requirements: Confirm whether requests must be submitted by fax email online portal or mail and document exact submission details contact information attention lines and provider-specific requirements.
Determine Request Requirements: Identify when requests need to be separated by record type custodian or date of service.
Prepare Request Information: Ensure authorization documents and request packets meet provider-specific requirements including required language or provider-specific forms when applicable.
Maintain Provider Information: Research existing records before adding new entries and maintain accurate complete and duplicate-free provider information.
Research and Verify Information: Use available databases healthcare system websites provider resources NPI information vendor portals and other reliable sources to verify details. Phone verification may also be required.
Resolve Issues: Investigate rejected or delayed requests identify the cause make appropriate corrections and escalate issues when necessary.
Maintain Accurate Documentation: Clearly document research findings submission requirements provider information and updates so other team members can act on the information.

Required Qualifications

Excellent written English with strong attention to detail.
Strong research and information-verification skills.
Ability to analyze multiple sources and identify accurate information.
Strong organizational and documentation skills.
Ability to identify discrepancies missing information and duplicate records.
Comfortable working independently and following established processes.
Strong problem-solving and follow-up skills.
Ability to work a schedule that overlaps with U.S. Eastern Time business hours.

Skills Assessment

Shortlisted candidates may be asked to complete a timed skills assessment independently and without the use of AI tools.

The assessment may evaluate:

Identifying healthcare providers custodians and billing entities
Determining when requests should be separated
Verifying submission methods and provider-specific requirements
Understanding basic HIPAA authorization requirements
Research persistence and information verification
Identifying errors gaps and duplicate information
Knowing when to resolve an issue independently and when to escalate

Prior medical records experience is not required. The assessment focuses on research reasoning accuracy and problem-solving skills.

Preferred Experience

Experience in any of the following areas is an advantage:

Researching healthcare providers facilities or billing entities
Release of Information (ROI)
Health Information Management (HIM)
Medical billing
Experience with UB-04 or CMS-1500 claim forms
NPI lookups and verification
Explanation of Benefits (EOBs)
Legal support particularly personal injury or medical malpractice
Medical records retrieval or release processes
Experience working with record-release or healthcare information vendors

Key Skills

Healthcare provider research
Data verification and accuracy
Document and information review
Medical billing knowledge
Research and investigation
Database management
Attention to detail
Written communication
Problem-solving
Organization and follow-through

What We Offer

Full-time remote work
Opportunity to develop experience in healthcare information and medical records processes
Opportunities for advancement into senior validation provider data quality or team leadership roles
A collaborative fast-paced work environment focused on accuracy and continuous improvement

Apply here:

Apply Now

About Company

OpsArmy

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Provider Validation Specialist

Makati City - Philippines

Job Summary

About Company

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