Remote Credentialing Specialist
: Job Details :

Credentialing Specialist

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, and 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.

Skills and Requirements:

• 2+ years of provider credentialing experience, especially with payers (Optum is a must)
• Experience submitting files in accordance with NCQA standards
• Familiarity with state-specific credentialing requirements
• Previous experience working for a CVO (Credentials Verification Organization)
• Experience working in a team environment
• 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
• Familiarity or experience with provider enrollment or medical licensing
• Startup experience null

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal employment opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment without regard to race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances.