Responsibilities:
Ensure credentialing files are being completed in a timely and accurate manner
Adhere to Medallion internal SLAs
Complete primary source verifications
Education and Board verifications
State Licenses
Reviewing credentialing files and marking them as ready to complete the credentialing
process
Resolve day-to-day questions and blockers for your team and escalate priority issues when
needed
Participate in team meetings alongside other team members to discuss credentialing issues,
provide feedback to product and engineering, and discuss process improvement changes
Communicating with providers through the credentialing process, assigning out tasks and
following up on outstanding tasks
We are a company committed to creating inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity employer that believes everyone matters. Qualified candidates will receive consideration for employment opportunities without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, disability, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to
Human Resources Request Form. The EEOC "Know Your Rights" Poster is available
here.
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https://insightglobal.com/workforce-privacy-policy/ .
2+ years of provider credentialing experience, especially with payers (Optum is a must)
Experience submitting files in accordance with NCQA standards
Familiarity with state-specific credentialing requirements
Previous experience working for a CVO (Credentials Verification Organization)
Experience working in a team environment
High attention to detail including effective communications at all organizational levels
Demonstrated organizational skills and ability to adhere to timelines and SLA metrics
Expertise in using GSuites tools include GSheets, GDocs, and GMail
Familiarity or experience with provider enrollment or medical licensing
Startup experience
Benefit packages for this role will start on the 31st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.