Credentialing Specialist

Oscar Health; United States; Remote; USD 22,000 - 31,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401(k) plan

Job summary

Oscar Health is seeking a Credentialing Specialist to join our Provider Credentialing team. This remote, production-driven role handles day-to-day credentialing activities and provider interactions within standard SOPs. You will report to the Manager, Provider Credentialing and work from anywhere in the U.S.

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.

Qualifications

• High school diploma or GED
• 1+ years in a fast-paced, volume-based or customer service environment
• Strong verbal and written communication skills
• Strong quantitative or analytical skills
• In-depth knowledge of health insurance
• Credentialing or provider-facing experience
• Accurate data manipulation/entry in production environments
• Advanced Google Suite or Microsoft Office capabilities

Responsibilities

• Develop understanding of credentialing processes, procedures, and tools
• Interact daily with providers or internal Oscar teams
• Manage assigned caseload, maintaining service delivery, productivity and quality
• Form working relationships with internal and external stakeholders
• Support leadership by identifying issues through escalation pathways
• Monitor and track health of all assigned work-in-progress issues
• Escalate and resolve issues to ensure timely turnaround
• Participate in process-improvement initiatives
• Comply with PHI-related operational, regulatory and compliance standards
• Comply with all applicable laws and regulations

Skills

Verbal and written communication

Quantitative/analytical skills

Health insurance knowledge

Credentialing experience

Data entry in production environment

Google Suite / MS Office

Education

High school diploma or GED

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
• 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: For information about our collection, use, and disclosure of applicants’ personal information as well as applicants’ rights over their personal information, please see our Privacy Policy .

Voluntary Self-Identification

For government reporting purposes, we ask candidates to respond to the below self-identification survey.Completion of the form is entirely voluntary. Whatever your decision, it will not be considered in the hiringprocess or thereafter. Any information that you do provide will be recorded and maintained in aconfidential file.

As set forth in Oscar Health’s Equal Employment Opportunity policy,we do not discriminate on the basis of any protected group status under any applicable law.

If you believe you belong to any of the categories of protected veterans listed below, please indicate by making the appropriate selection.As a government contractor subject to the Vietnam Era Veterans Readjustment Assistance Act (VEVRAA), we request this information in order to measurethe effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA. Classification of protected categoriesis as follows:

A "disabled veteran" is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability.

A "recently separated veteran" means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service.

An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.

An "Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.