Job Mission:

As a Specialist, you will be joining our Credentialing Operations team and working on our Practitioner Credentialing. You’ll be handling exceptions to an automated process, by doing research about provider credentials that our automated tools could not solve and reaching out to stakeholders for missing information. You’ll be held to a high standard for quality of work and will be a contributor to the quality control process.

Outcomes:

• Completing primary source verifications for our practitioner credentialing clients;

• Conducting internal, or online, research into verifications of provider information;

• Reviewing credentials and determining whether or not they need to be escalated to the larger operations team, compliance, or product/engineering.

• Highlighting trends to Operations Analysts to address areas for improvements in business processes.

About You

Competencies:

1. Written and Verbal Communication — You’re able to take several complex ideas and  summarize them for different audiences
2. Time Management/Multi-Tasking — You’re able to dedicate the necessary amount of time to each project or issue that arises and provide solutions, results, and deliverables.
3. Problem Solving/Critical Thinking — You are able to figure out solutions that others may have missed.  You are able to work both independently and as a team player when it comes to tackling issues that seem impossible.
4. Enthusiasm for Innovation — You are always looking for new ways to improve or build upon current ideas and processes and open to all ideas put forth by yourself or team members.
5. Process Oriented - You’re able to go heads down and work through a large amount of work while also assessing the improvements you could make to the process overall

 Additional Attributes:

• At least 1-3 years working in the healthcare industry; bonus points if you have practitioner credentialing experience. Relevant experience may also include conducting web research in a business environment and/or data entry

• Attentive to detail; able to spot issues and complete root cause analysis

• You’re comfortable working independently and also contributing as part of a team

• Tech-wise, you are comfortable navigating Excel spreadsheets, working with Google products, and using third party sources to complete work.

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