Credentialing Specialist

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.

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

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.
• At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Artificial Intelligence (AI):

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Reasonable Accommodation:

Oscar applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.

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