Remote Credentialing Specialist

Insight Global; United States; Remote; USD 50,000 - 60,000; Full time

Job summary

A leading healthcare solutions provider is seeking a Remote Credentialing Specialist to join their team. In this role, you will manage the credentialing process for providers, ensuring accuracy and efficiency in licensing tasks. Candidates should have at least 2 years of provider credentialing experience and be knowledgeable about NCQA standards. This position demands strong organizational skills and effective communication to facilitate a smooth onboarding experience for clinicians. A team-oriented approach and proficiency in GSuites tools are essential.

Qualifications

• Minimum 2 years of provider credentialing experience.
• Experience working at or with a Credentialing Verification Organization (CVO).
• Knowledge of NCQA standards and delegated credentialing.

Responsibilities

• Ensure credentialing files are completed timely and accurately.
• Adhere to internal SLAs within the team.
• Communicate with providers throughout the credentialing process.

Skills

Provider credentialing experience

Understanding of credentialing lifecycle

Knowledge of NCQA standards

High attention to detail

Organizational skills

Expertise in GSuites tools

Credentialing behavioral health providers

Job description

Job Title: Remote Credentialing Specialist

Location: Remote

Salary Range: $50,000-$60,0000

Must Haves

• 2+ years of provider credentialing experience
• Experience working at or with a CVO (Credentialing Verification Organization), understanding the end-to-end credentialing lifecycle
• Knowledge of NCQA standards, delegated credentialing, and/or CAQH workflows.
• High attention to detail including effective communications at all organizational levels
• Demonstrated organizational skills and ability to adhere to timelines and SLA metrics
• Expertise in using GSuites tools include GSheets, GDocs, and GMail
• Experience credentialing behavioral health provider types

Plusses:

• Experience working at a startup is a bonus
• Experience working at any of these firms: Radiology Partners, Verisys, Altais, Symplr
• Experience working in a team environment

Role Overview

Our Credentialing team is core to our business and is responsible for making sure all of the licensing and credentialing tasks that we take on for our customers is completed efficiently and accurately. As a Credentialing Specialist, you will be responsible for primary source verifications and ensuring the completion of credentialing files. Your work is critical to creating a seamless onboarding experience for clinicians.

What you'll do

• Ensure credentialing files are being completed in a timely and accurate manner
• Adhere to Medallion internal SLAs
• Complete primary source verifications
• Education and Board verifications
• State Licenses
• Reviewing credentialing files and marking them as ready to complete the credentialing process
• Resolve day-to-day questions and blockers for your team and escalate priority issues when needed
• Participate in team meetings alongside other team members to discuss credentialing issues, provide feedback to product and engineering, and discuss process improvement changes
• Communicating with providers through the credentialing process, assigning out tasks and following up on outstanding tasks