Credentialing Specialist

About the role

The Credentialing Specialist is a volume-driven production based role that handles the day-to-day activities involved in running a health insurance company including provider interactions as well as back office credentialing tasks in accordance with standard operating procedures. You will report into the Manager, Provider Credentialing. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Texas. #LI-Remote Pay Transparency: The base pay for this role is $19 per hour. You are also eligible for employee benefits, and monthly vacation accrual at a rate of 15 days per year.

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

Requirements

• High school diploma or GED
• 1+ years of experience in a fast-paced, volume-based or customer service-oriented environment
• Bonus points:
• 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
• This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here .
• Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.
• California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy .

Benefits

Additional Information

Hi, we're Oscar. We're hiring a Credentialing Specialist to join our Provider Credentialing team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves-one that behaves like a doctor in the family.

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