Credentialing Specialist II

This is a fully remote position, open to applicants in United States.

📋 Description

• Manage the onboarding process for providers, including the integration of CVO data into relevant systems.

• Verify that all necessary documentation is complete, precise, and compliant with industry and organizational standards.

• Follow up with providers regarding outstanding applications and required information.

• Conduct primary source verifications in accordance with departmental policies and NCQA standards when not completed by CVO.

• Develop and accurately maintain provider information across various systems.

• Address inquiries related to the status of provider applications.

• Utilize organizational templates to inform providers about their application status.

• Assist the Credentialing Specialist I with their functional responsibilities.

⛳️ Requirements

• An associate degree or a comparable mix of education and experience.

• A minimum of 3 years of credentialing experience, ideally in a managed care environment.

• Ensure internet service is adequate for essential job functions; at least 50 Mbps download and 10 Mbps upload speed while hardwired and not connected to a VPN.

• Familiarity with NCQA standards and payer credentialing requirements.

• Understanding of the vision, dental, or hearing industries.

• Proficient in computer skills, data entry, and clerical tasks.

• CPCS certification is preferred.

🏝️ Benefits

• Opportunities for skill enhancement, leadership development, and community service.

• Comprehensive medical, dental, supplemental health, life, and vision insurance for employees and their dependents with no waiting period.

• Life and disability insurance coverage.

• 401(k) plan with company matching contributions.

• Tuition assistance programs.

• Paid parental leave.

• Backup family care options.

• Innovative and modern work environments that encourage collaboration and creativity.

• Flexible policies regarding time off, dress code, and work locations.

• Employee Resource Groups.

• Opportunities for social responsibility and community volunteering.