Remote Credentialing Specialist – NCQA & PSV

VIVA USA Inc; United States; À distance; USD 42 000 - 65 000; Plein temps

Résumé du poste

VIVA USA Inc. is seeking a Credentialing Specialist to guide clinicians through the client credentialing process in a fully remote U.S. environment.

You will assist with credentialing applications, perform primary source verifications, and maintain the MD Staff credentialing database, ensuring compliance with NCQA, URAC, and state/federal requirements. Responsibilities include reviewing credentialing and re-credentialing files, maintaining licenses and certifications, coordinating with the

Qualifications

• 1-3 years of successful work experience in a credentialing role/department.
• Familiar with NCQA accreditation standards.
• Demonstrate active listening and the ability to provide/receive feedback.
• Strong interpersonal skills to build rapport with stakeholders.
• Proficient with Google Suite and credentialing systems.

Responsabilités

• Review and process credentialing and re-credentialing files.
• Establish and maintain a system for timely processing of credentialing files per NCQA policies.
• Query organizations and evaluate responses to ensure NCQA standards compliance.
• Maintain copies of current state licenses, DEA, malpractice coverage, and other credentialing docs.
• Review background checks, drug tests, and TB screenings and record results.
• Assemble verified information and prepare files for Credentialing Committee.
• Verify providers’ requirements for approval to work in specific states/plans.
• Assist with ongoing monitoring of contracted clinicians.
• Use MD Staff credentialing database to run queries, generate reports, and improve efficiency.
• Provide administrative support to department leadership and stakeholders.
• Maintain professionalism and timely responses to emails.
• Demonstrate teamwork and assist with special projects.
• Protect PHI and ensure privacy during work activities.

Connaissances

Credentialing experience

Active listening

Interpersonal skills

Time management

Communication skills

Formation

High school diploma or equivalent

Outils

Google Suite

MD Staff system

Description du poste

VIVA USA Inc. is seeking a Credentialing Specialist to guide clinicians through the client credentialing process in a fully remote U.S. environment.

You will assist with credentialing applications, perform primary source verifications, and maintain the MD Staff credentialing database, ensuring compliance with NCQA, URAC, and state/federal requirements. Responsibilities include reviewing credentialing and re-credentialing files, maintaining licenses and certifications, coordinating with the