Credentialing Specialist

Oscar Health•New York, NY

6d•Remote

About The Position

Oscar is hiring a Credentialing Specialist to join their Provider Credentialing team. Oscar is a health insurance company built on a technology platform with a focus on serving its members. The Credentialing Specialist role is a volume-driven, production-based position that handles the daily activities of running a health insurance company, including provider interactions and back-office credentialing tasks, following standard operating procedures.

Requirements

High school diploma or GED
1+ years of experience in a fast-paced, volume-based or customer service-oriented environment

Nice To Haves

Strong verbal and written communication skills
Strong quantitative or analytical skills focused on proactively identifying or solving problems
In-depth knowledge of health insurance
Credentialing or provider facing experience
Experience manipulating and entering accurate data in a production driven environment
Advanced Google Suite or Microsoft Office capabilities or willingness to learn

Responsibilities

Develop a comprehensive understanding of the current processes, procedures, and tools associated with credentialing.
Interact daily with providers or internal Oscar teams according to assignment needs.
Manage an assigned caseload while maintaining service delivery, productivity, and quality expectations.
Form working relationships with internal and external stakeholders.
Support the leadership team by identifying issues through established escalation pathways.
Be accountable for monitoring and tracking the health of all assigned work-in-progress issues.
Escalate and resolve issues to ensure appropriate turnaround times.
Be an active participant in process improvement initiatives.
Comply with all operational, regulatory, and compliance standards relating to member Personal Health Information (PHI).
Compliance with all applicable laws and regulations.
Other duties as assigned.