Credentialing Specialist

name; United States; Remote; USD 46,287,000 - 62,543,000; Full time

Benefits offered by this job

Benefits package

Vacation accrual 15 days/year

Job summary

Oscar Health is hiring a Credentialing Specialist to join our Provider Credentialing team in a fully remote role open to residents in AZ, FL, GA, and TX. This is a volume-driven, production-based position handling day-to-day credentialing tasks and provider interactions in line with SOPs.

You will report to the Manager, Provider Credentialing, manage a caseload, participate in process improvements, ensure PHI compliance, and contribute to delivering timely, accurate credentialing services across

Qualifications

• High school diploma or GED required.
• 1+ years of experience in a fast-paced, volume-based or customer service-oriented environment.
• Credentialing or provider-facing experience is a plus.
• In-depth knowledge of health insurance is a plus.
• Strong verbal and written communication and data-entry accuracy are important.

Responsibilities

• Develop a comprehensive understanding of credentialing processes, procedures, and tools.
• Interact daily with providers or internal teams according to assignment needs.
• Manage an assigned caseload while maintaining service delivery, productivity, and quality expectations.
• Establish working relationships with internal and external stakeholders.
• Support leadership by identifying issues through established escalation pathways.
• Monitor and track the health of all assigned work-in-progress issues.
• Escalate and resolve issues to ensure appropriate turnaround times.
• Participate in process improvement initiatives.

Skills

Strong verbal and writtenCommunication

Analytical skills

Health insurance knowledge

Credentialing or provider facing

Data entry accuracy

Google Suite / Microsoft Office

Education

High school diploma or GED

Tools

Google Suite

Microsoft Office

Job description

Hi, we're Oscar. We're hiring a Credentialing Specialist to join our Provider Credentialing team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role

The Credentialing Specialist is a volume-driven production based role that handles the day-to-day activities involved in running a health insurance company including provider interactions as well as back office credentialing tasks in accordance with standard operating procedures.

You will report into theManager, Provider Credentialing.

Work Location

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Texas. #LI-Remote

Pay Transparency

The base pay for this role is $19 per hour. You are also eligible for employee benefits, and monthly vacation accrual at a rate of 15 days per year.

Responsibilities

• Develop a comprehensive understanding of the current processes, procedures, and tools associated with credentialing.
• Interact daily with providers or internal Oscar teams according to assignment needs
• Manage an assigned caseload while maintaining service delivery, productivity, and quality expectations
• Form working relationships with internal and external stakeholders.
• Support the leadership team by identifying issues through established escalation pathways
• Be accountable for monitoring and tracking the health of all assigned work-in-progress issues.
• Escalate and resolve issues to ensure appropriate turnaround times
• Be an active participant in process improvement initiatives
• Comply with all operational, regulatory, and compliance standards relating to member Personal Health Information (PHI)
• Compliance with all applicable laws and regulations
• Other duties as assigned

Requirements

• High school diploma or GED
• 1+ years of experience in a fast-paced, volume-based or customer service-oriented environment

Bonus points

• Strong verbal and written communication skills
• Strong quantitative or analytical skills focused on proactively identifying or solving problems
• In-depth knowledge of health insurance
• Credentialing or provider facing experience
• Experience manipulating and entering accurate data in a production driven environment
• Advanced Google Suite or Microsoft Office capabilities or willingness to learn

This is an authentic Oscar Health job opportunity.

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency

Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI)

Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

Reasonable Accommodation

Oscar applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team ([e-mail]) to make the need for an accommodation known.

California Residents

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