• Remote Credentialing Specialist

    Insight Global (New York, NY)


    Job Description

    Responsibilities:

    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

     

    We are a company committed to creating inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity employer that believes everyone matters. Qualified candidates will receive consideration for employment opportunities without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, disability, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to Human Resources Request Form (https://airtable.com/app21VjYyxLDIX0ez/shrOg4IQS1J6dRiMo) . The EEOC "Know Your Rights" Poster is available here (https://www.eeoc.gov/sites/default/files/2023-06/22-088\_EEOC\_KnowYourRights6.12ScreenRdr.pdf) .

     

    To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ .

     

    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 oruniformed service member status, or any other status or characteristic protected by applicable laws, regulations, andordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or the recruiting process, please send a request to [email protected].