Sr. Specialist, Credentialing
Oscar Health
•Remote
About The Position
Oscar is seeking a Sr. Specialist, Credentialing to join their Provider Operations team. This role involves solving complex issues within the provider credentialing process, acting as a subject matter expert, and collaborating cross-functionally. The specialist will track and trend credentialing issues, partner with stakeholders to resolve escalated issues, and support process improvement initiatives for the credentialing team. Oscar is a health insurance company built on a technology platform with a focus on member service.
Requirements
- 1+ years of credentialing experience for facilities, adhering to NCQA standards
- 2+ years previous work experience in a fast-paced volume-based environment
- 2+ years strong quantitative or analytical skills focused on proactively identifying or solving problems
- Experience working in health insurance
Nice To Haves
- Bachelor's Degree
- High school diploma or GED
- 1+ years of credentialing experience for practitioners, adhering to NCQA standards
- Background in health insurance
- Proficiency with non Microsoft business platforms
- Proficiency in using a credentialing or provider data repository
- Primary Source Verification
- Experience with healthcare data such as provider data
- Strong verbal and written communications, and interpersonal interactions
Responsibilities
- Support, manage, or escalate complex issues that are not solved using conventional workflows.
- Effectively manage internal or external escalated transactions and communicate with appropriate parties for effective resolution in adherence to SLAs
- Act as a point person for stakeholders in other areas of the business to improve feedback loops and trend facility and provider credentialing issues
- Manage queue work and assigned caseload through efficient dashboard management
- Collaborate daily with production and credentialing leaders on systemic issues and communicate blockers to care and satisfaction
- Compliance with all applicable laws and regulations
- Other duties as assigned
Benefits
- medical
- dental
- vision benefits
- 11 paid holidays
- paid sick time
- paid parental leave
- 401(k) plan participation
- life and disability insurance
- paid wellness time and reimbursements
- monthly vacation accrual at a rate of 15 days per year
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
High school or GED
