Quality Assurance Auditor

Certify; Ciudad de México, Monterrey, Guadalajara; A distancia; USD 40,000 - 80,000; Jornada completa

Descripción de la vacante

Join a forward-thinking company dedicated to transforming healthcare data infrastructure. As a core member of the credentialing team, you will ensure accurate credentialing of healthcare professionals while building essential processes for a growing team. This fully remote role offers you the chance to make a significant impact in a meritocratic environment where your contributions are valued. If you have a passion for healthcare and a keen eye for detail, this opportunity is perfect for you.

Formación

• 2+ years of experience in credentialing or healthcare operations.
• Knowledge of NCQA credentialing standards is preferred.

Responsabilidades

• Build and maintain an effective audit process for credentialing.
• Perform timely and accurate audit reviews and provide feedback.

Conocimientos

Credentialing

Provider Data Management

Auditing

Healthcare Operations

Communication Skills

Attention to Detail

Descripción del empleo

About Certify

At CertifyOS, we're building the infrastructure that powers the next generation of provider data products, making healthcare more efficient, accessible, and innovative. Our platform is the ultimate source of truth for provider data, offering unparalleled ease and trust while making data easily accessible and actionable for the entire healthcare ecosystem.

What sets us apart? Our cutting-edge, API-first, UI-agnostic, end-to-end provider network management platform automates licensing, enrollment, credentialing, and network monitoring like never before. With direct integrations into hundreds of primary sources, we have an unbeatable advantage in enhancing visibility into the entire provider network management process. Plus, our team brings over 25+ years of combined experience building provider data systems at Oscar Health, and we're backed by top-tier VC firms who share our bold vision of creating a healthcare cloud that eliminates friction surrounding provider data.

But it's not just about the technology; it's about the people behind it. At Certify, we foster a meritocratic environment where every voice is heard, valued, and celebrated. We're founded on principles of trust, transparency, and accountability, and we're not afraid to challenge the status quo. We're seeking purpose-driven individuals to join us as we redefine healthcare data infrastructure.

About the role

We are looking for our next core credentialing team member! You will play an integral part in ensuring the timely and accurate credentialing of healthcare professionals in accordance with company, regulatory, and client requirements. As an early employee, you'll have significant responsibility in building infrastructure for a growing team. This is a fully remote role reporting to the Associate Director of Credentialing.

What you'll do:

1. Build a comprehensive, effective, and efficient audit process.
2. Complete initial and ongoing quality audits for credentialing applications.
3. Perform audit reviews in a timely, efficient, and accurate manner.
4. Provide constructive feedback and education to peers and teams.
5. Utilize audit results to identify, document, test the effectiveness of internal processes and controls, and develop sound conclusions.
6. Track and trend audit results and notify leadership to administer appropriate education and coaching for team members.

What you'll need:

1. 2+ years of credentialing, provider data management, auditing, or healthcare operations experience.
2. 1 year of credentialing auditing experience or similar.
3. Professional written and verbal communication skills.
4. Close attention to detail and ability to apply audit techniques.
5. Knowledge of NCQA credentialing standards is preferred.

At Certify, we're committed to creating an inclusive workplace where everyone feels valued and supported. As an equal opportunity employer, we celebrate diversity and warmly invite applicants from all backgrounds to join our vibrant community.