Credentialing Services Specialist

Valenz Group; United States; Remoto; USD 45.000 - 65.000; Tempo pieno

Vantaggi offerti da questo lavoro

Medical, Dental, Vision insurance

Flexible working environment

Paid time off

401(k) with company match

Wellness and support programs

Descrizione del lavoro

Valenz Group is seeking a Credentialing Services Specialist for a fully remote role based in the United States. You will verify credentials, monitor sanctions, and support clients across credentialing platforms. Attention to detail and strong communication are essential to maintain timely, compliant processes.

Responsibilities include handling system access, reporting, issue resolution, and documentation to support audits and compliance across healthcare providers and organizations.

Competenze

• Strong attention to detail and accurate record-keeping for compliance-sensitive information.
• Ability to learn credentialing, compliance, and client-support systems and follow procedures.
• Excellent verbal and written communication for internal and external clients.

Mansioni

• Perform credentialing, sanction monitoring, and verification activities for employees and providers.
• Manage client credentialing and compliance reporting within timeframes.
• Provide client support related to credentialing systems and workflows.
• Guide clients through credentialing processes and troubleshoot issues.
• Document, track, and monitor client questions and service requests through resolution.
• Review activity for accuracy and compliance with procedures and client requirements.
• Maintain records to support credentialing, audit, and compliance activities.

Conoscenze

Attention to detail

Strong communication

Problem solving

Organizational skills

Time management

Customer service

Discretion with confidential data

Independent work

Formazione

High school diploma

Strumenti

Microsoft Excel

Credentialing systems

Descrizione del lavoro

Vālenz Health® is the destination for employers, brokers, payers, and providers to reduce costs, improve quality, and elevate the healthcare experience. Through advanced technology and clinical expertise, Valenz creates a distinctly different approach to a complex healthcare system. With our solutions, we execute across the entire healthcare journey — from member experience to payment integrity, provider quality, and plan performance. With one of America’s largest cost, quality and utilization datasets, we create greater transparency, flexibility, and cost containment — empowering members and employers with the information they need to make smarter, more cost-effective decisions.

About This Opportunity:

As a Credentialing Services Specialist, you’ll support credentialing and sanction monitoring services for healthcare organizations by completing verification activities, managing compliance-related reporting, and providing client support across credentialing platforms and processes. You’ll help ensure credentialing and monitoring activities are completed accurately and within required timeframes while assisting clients with system, account, and process-related questions or issues. You’ll also maintain detailed documentation and support compliance with applicable federal, state, client, and organizational requirements.

Things You’ll Do Here:

• Performs credentialing, sanction monitoring, and verification activities for employees, providers, vendors, and other applicable individuals or entities.
• Manages client credentialing and compliance reporting and ensures required reports are completed accurately and within established or mandated timeframes.
• Provides client support related to credentialing systems, sanction monitoring processes, account access, reporting, and other service-related questions.
• Guides clients through credentialing and sanction monitoring workflows and provides troubleshooting support when issues arise.
• Researches, identifies, and resolves system, data, account, and process-related issues or escalates matters when additional support is required.
• Responds to client inquiries through phone, email, and other communication channels in a timely and professional manner.
• Documents, tracks, and monitors client questions, service requests, and issues through resolution.
• Reviews account activity and reporting for accuracy, completeness, and compliance with established procedures and client requirements.
• Maintains accurate records and documentation to support credentialing, sanction monitoring, audit, and compliance activities.
• Communicates identified discrepancies, risks, or unresolved issues to appropriate internal or client stakeholders.
• Collaborates with internal teams to resolve client issues, improve service delivery, and support effective credentialing operations.
• Maintains knowledge of credentialing procedures, sanction monitoring requirements, systems, and applicable compliance standards.
• Follows established company policies, procedures, confidentiality requirements, and data security standards.
• Performs other related duties and supports departmental initiatives as assigned. Reasonable accommodation may be made to enable individuals with disabilities to perform essential duties.

What You’ll Bring to the Team:

• High school diploma or equivalent required.
• Strong attention to detail with the ability to maintain accurate records and manage compliance-sensitive information.
• Strong critical thinking, research, and problem-solving skills with the ability to identify discrepancies and resolve routine issues independently.
• Excellent verbal and written communication skills with the ability to provide professional support to internal and external clients.
• Strong organizational and time-management skills with the ability to manage multiple priorities and meet established deadlines.
• Proficiency with Microsoft Office applications, including Excel, with the ability to work effectively with spreadsheets, reports, and data.
• Ability to learn and effectively use credentialing, compliance, and client support systems.
• Demonstrated ability to follow established procedures, work independently, and complete assignments accurately with appropriate escalation when needed.
• Strong customer service orientation with the ability to remain responsive, professional, and solution-focused.
• Ability to handle confidential and sensitive healthcare and business information with discretion.

A plus if you have…

• Previous experience working within healthcare, medical billing, claims, provider services, healthcare administration, or a related environment.
• Experience in healthcare administration, compliance, customer service, provider services, or a related environment.
• Working knowledge of healthcare terminology and claim information, including familiarity with ICD-10, CPT/HCPCS, revenue codes, billed charges, and other healthcare data elements.
• Familiarity with healthcare provider information, billing terminology, and common claim documentation.
• Experience working in healthcare cost containment, medical bill review, payment integrity, TPA, health plan, or related healthcare services.

Where You’ll Work:

This is a fully remote position, and we’ll provide all the necessary equipment!

• Work Environment: You’ll need a quiet workspace that is free from distractions.
• Technology: Reliable internet connection—if you can use streaming services, you’re good to go!
• Security: Adherence to company security protocols, including the use of VPNs, secure passwords, and company-approved devices/software.
• Location: You must be US based, in a location where you can work effectively and comply with company policies such as HIPAA.

Why You’ll Love Working Here

Our mission is to advance healthcare through technology and expertise to optimize cost, quality, access, and utilization for all. We bring that mission to life through our commitment to Collaboration, Performance, Transparency, and Trust—the core values that guide how we work with our members, our customers, and each other.

Benefits

• Generously subsidized company-sponsored Medical, Dental, and Vision insurance, with access to services through our own products, Healthcare Blue Book and KISx Card.
• Spending account options: HSA, FSA, and DCFSA
• 401K with company match and immediate vesting
• Flexible working environment
• Generous Paid Time Off to include vacation, sick leave, and paid holidays
• Employee Assistance Program that includes professional counseling, referrals, and additional services
• Paid maternity and paternity leave
• Pet insurance
• Employee discounts on phone plans, car rentals and computers
• Community giveback opportunities, including paid time off for philanthropic endeavors

At Valenz, we celebrate, support, and thrive on inclusion, for the benefit of our associates, our partners, and our products. Valenz is committed to the principle of equal employment opportunity for all associates and to providing associates with a work environment free of discrimination and harassment. All employment decisions at Valenz are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion or belief, national, social, or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate. We will not tolerate discrimination or harassment based on any of these characteristics.