Description

You will solve complex issues impacting provider credentialing, act as a subject matter expert, and work cross-functionally to resolve escalated issues and support process improvements.

Requirements

• 1+ years credentialing experience for facilities, adhering to NCQA standards
• 2+ years experience in fast-paced volume-based environment
• 2+ years strong quantitative/analytical skills for problem-solving
• Experience working in health insurance

Responsibilities

• Support, manage, or escalate complex credentialing issues
• Manage internal/external escalated transactions for effective resolution
• Act as point person for stakeholders to improve feedback loops
• Manage queue work and assigned caseload via dashboard management
• Collaborate with production and credentialing leaders on systemic issues