Sr. Specialist, Credentialing

2 hours, 5 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.
  • Handle internal and external escalated transactions and coordinate resolution in alignment with service-level agreements.
  • Serve as a point of contact for stakeholders across the business to improve feedback loops and resolve credentialing issues.
  • Track and trend provider and facility credentialing issues to identify recurring patterns and problem areas.
  • Manage queue work and assigned caseloads through effective dashboard management.
  • Collaborate daily with production and credentialing leaders on systemic issues and blockers affecting 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, high-volume 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 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.
  • Monthly vacation accrual at a rate of 15 days per year.
  • Remote work from home in Georgia.
  • Eligible for employee benefits.
  • 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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