Sr. Specialist, Credentialing

12 hours, 52 minutes ago
Full-time
Junior
Operations
Oscar

Oscar

Oscar is a health insurance company that offers plans for individuals, families, and small businesses. With a focus on humanizing health care through technology, design, and data, Oscar provides easy-to-understand bills, 24/7 access to doctors, and a p...

Insurance
1K-5K
Founded 2012

Description

  • Support, manage, or escalate complex credentialing issues that cannot be resolved through standard workflows.
  • Act as a subject matter expert for provider and facility credentialing.
  • Manage internal and external escalated transactions and communicate with the right stakeholders to resolve them within SLA requirements.
  • Track and trend provider and facility credentialing issues to improve feedback loops and identify systemic problems.
  • Serve as a point person for stakeholders across the business on credentialing issues and resolution efforts.
  • Manage queue work and assigned caseloads through efficient dashboard and workflow management.
  • Collaborate daily with production and credentialing leaders on systemic issues and communicate blockers that affect care and satisfaction.
  • Support process improvement efforts for the credentialing team.
  • Ensure compliance with all applicable laws and regulations.

Requirements

  • 1+ years of credentialing experience for facilities, adhering to NCQA standards.
  • 2+ years of experience in a fast-paced, volume-based environment.
  • 2+ years of strong quantitative or analytical experience focused on proactively identifying or solving problems.
  • Experience working in health insurance.
  • Bachelor's degree (preferred).
  • High school diploma or GED (preferred).
  • 1+ years of credentialing experience for practitioners, adhering to NCQA standards (preferred).
  • Background in health insurance (preferred).
  • Proficiency with non-Microsoft business platforms (preferred).
  • Proficiency in using a credentialing or provider data repository (preferred).
  • Experience with Primary Source Verification (preferred).
  • Experience with healthcare data such as provider data (preferred).
  • Strong verbal and written communication and interpersonal skills (preferred).

Benefits

  • Hourly pay of $24.00/hr.
  • Eligibility for employee benefits.
  • Monthly vacation accrual at a rate of 15 days per year.
  • Medical, dental, and vision insurance.
  • 11 paid holidays.
  • Paid sick time.
  • Paid parental leave.
  • 401(k) plan participation.
  • Life and disability insurance.
  • Paid wellness time and reimbursements.

Interested in this position?

Apply directly on the company website

Apply Now

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