Associate Credentialing Specialist

<section class="Job_column1__SMcVh"><h2 class="h6 text-red uppercase">AT A GLANCE</h2>The Associate Credentialing Specialist verifies and maintains healthcare provider qualifications (e.g. state licenses, education verification, certifications, work history) to ensure compliance with regulatory standards, manages provider enrollment with payers, updates databases, and acts as a liaison with providers, insurance companies, and internal departments, ensuring only qualified staff can practice.  </section><section class="Job_column2__EY2DH"><h2>What You’ll Do</h2><ul><li data-leveltext="●" data-font="Times New Roman" data-listid="2" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769242":[8226],"469777803":"left","469777804":"●","469777815":"multilevel"}" data-aria-posinset="1" data-aria-level="1">Verification: Authenticate degrees, licenses, board certifications, and work history.  </li></ul><ul><li data-leveltext="●" data-font="Times New Roman" data-listid="2" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769242":[8226],"469777803":"left","469777804":"●","469777815":"multilevel"}" data-aria-posinset="2" data-aria-level="1">Compliance: Ensure adherence to federal, state, and organizational regulations, updating as needed.  </li></ul><ul><li data-leveltext="●" data-font="Times New Roman" data-listid="2" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769242":[8226],"469777803":"left","469777804":"●","469777815":"multilevel"}" data-aria-posinset="3" data-aria-level="1">Data Management: Maintain accurate records in credentialing software (e.g., Medallion, CAQH, PECOS) and databases, tracking expirations.  </li></ul><ul><li data-leveltext="●" data-font="Times New Roman" data-listid="2" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769242":[8226],"469777803":"left","469777804":"●","469777815":"multilevel"}" data-aria-posinset="4" data-aria-level="1">Application Processing: Prepare, submit, and follow up on initial and re-credentialing applications with insurance payers and clients.</li></ul><ul><li data-leveltext="●" data-font="Times New Roman" data-listid="2" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769242":[8226],"469777803":"left","469777804":"●","469777815":"multilevel"}" data-aria-posinset="5" data-aria-level="1">Liaison: Communicate with providers, compliance teams, medical staff, and finance departments.  </li></ul><ul><li data-leveltext="●" data-font="Times New Roman" data-listid="2" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769242":[8226],"469777803":"left","469777804":"●","469777815":"multilevel"}" data-aria-posinset="6" data-aria-level="1">Auditing: Conduct audits and prepare reports for regulatory reviews.  </li></ul><ul><li data-leveltext="●" data-font="Times New Roman" data-listid="2" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769242":[8226],"469777803":"left","469777804":"●","469777815":"multilevel"}" data-aria-posinset="7" data-aria-level="1">Onboarding: Support timely onboarding of new providers by ensuring they are “in-network” and credentialed.  </li></ul><ul><li data-leveltext="●" data-font="Times New Roman" data-listid="2" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769242":[8226],"469777803":"left","469777804":"●","469777815":"multilevel"}" data-aria-posinset="8" data-aria-level="1">Malpractice Management: Submitting state-funded applications, as needed. </li></ul><ul><li data-leveltext="●" data-font="Times New Roman" data-listid="2" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769242":[8226],"469777803":"left","469777804":"●","469777815":"multilevel"}" data-aria-posinset="9" data-aria-level="1">Revenue Cycle Support: Oversee the activation of credentialed providers in company EMR to ensure all elements are met for successful billable patient visit scheduling.   </li></ul><ul><li data-leveltext="●" data-font="Times New Roman" data-listid="2" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769242":[8226],"469777803":"left","469777804":"●","469777815":"multilevel"}" data-aria-posinset="10" data-aria-level="1">Other duties as assigned.  </li></ul><h2>What We’re Looking For</h2>Required:  <ul><li data-leveltext="●" data-font="Times New Roman" data-listid="3" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769242":[8226],"469777803":"left","469777804":"●","469777815":"multilevel"}" data-aria-posinset="1" data-aria-level="1">Minimum of 3 years of experience in provider credentialing for a practice or hospital setting   </li></ul><ul><li data-leveltext="●" data-font="Times New Roman" data-listid="3" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769242":[8226],"469777803":"left","469777804":"●","469777815":"multilevel"}" data-aria-posinset="2" data-aria-level="1">Knowledge of PECOS and CAQH processes  </li></ul><ul><li data-leveltext="●" data-font="Times New Roman" data-listid="3" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769242":[8226],"469777803":"left","469777804":"●","469777815":"multilevel"}" data-aria-posinset="3" data-aria-level="1">Strong verbal and written communication skills  </li></ul><ul><li data-leveltext="●" data-font="Times New Roman" data-listid="3" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769242":[8226],"469777803":"left","469777804":"●","469777815":"multilevel"}" data-aria-posinset="4" data-aria-level="1">Critical thinking and problem-solving </li></ul><ul><li data-leveltext="●" data-font="Times New Roman" data-listid="3" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769242":[8226],"469777803":"left","469777804":"●","469777815":"multilevel"}" data-aria-posinset="5" data-aria-level="1">Ability to multitask, manage competing priorities, and maintain accurate records </li></ul>Preferred Qualifications:  <ul><li data-leveltext="●" data-font="Times New Roman" data-listid="1" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769242":[8226],"469777803":"left","469777804":"●","469777815":"multilevel"}" data-aria-posinset="1" data-aria-level="1">Experience supporting provider credentialing remotely in a healthcare setting. </li></ul><ul><li data-leveltext="●" data-font="Times New Roman" data-listid="1" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769242":[8226],"469777803":"left","469777804":"●","469777815":"multilevel"}" data-aria-posinset="2" data-aria-level="1">Experience with Medallion  </li></ul>Pursuant to various state Fair Pay Acts, below is a summary of compensation elements for this role at the company. The following benefits are provided by RVO Health, subject to eligibility requirements.<ul><li style="font-weight: 400;">Starting Salary: $48,000 - $60,000  *Note actual salary is based on geographic location, qualifications and experience</li><li style="font-weight: 400;">Health Insurance Coverage (medical, dental, and vision)</li><li style="font-weight: 400;">Life Insurance</li><li style="font-weight: 400;">Short and Long-Term Disability Insurance</li><li style="font-weight: 400;">Flexible Spending Accounts</li><li style="font-weight: 400;">Paid Time Off</li><li style="font-weight: 400;">Holiday Pay</li><li style="font-weight: 400;">401(k) with match</li><li style="font-weight: 400;">Employee Assistance Program</li><li style="font-weight: 400;">Paid Parental Bonding Benefit Program</li><li style="font-weight: 400; color: rgb(0, 0, 0);">Pharmacy Benefits</li><li style="font-weight: 400; color: rgb(0, 0, 0);">Income Protection Plans</li><li style="font-weight: 400; color: rgb(0, 0, 0);">Pet Services Plans</li><li style="font-weight: 400; color: rgb(0, 0, 0);">Mental Health Support</li><li style="font-weight: 400; color: rgb(0, 0, 0);">Wellness Coaching</li><li style="font-weight: 400; color: rgb(0, 0, 0);">HSA- Health Savings Account</li><li style="color: rgb(0, 0, 0);">Commuter Benefits</li><li>Gym & Fitness Center Discount Program</li></ul>Who We Are: Founded in 2022, RVO Health is a new healthcare platform of digital media brands, services and technologies focused on building relationships with people throughout their health & wellness journey. We meet people where they are in their personal health journeys and connect them with both the information and the care they need. RVO Health was created by joining teams from both Red Ventures and UnitedHealth Group’s Optum Health. Together we’re focused on delivering on our vision of a stronger and healthier world. RVO Health is comprised of Healthline Media (Healthline, Medical News Today, Psych Central, Greatist and Bezzy), Healthgrades, FindCare and PlateJoy; Optum Perks, Optum Store and the virtual coaching platforms Real Appeal, Wellness Coaching, and QuitForLife. We offer competitive salaries and a comprehensive benefits program for full-time employees, including medical, dental and vision coverage, paid time off, life insurance, disability coverage, employee assistance program, 401(k) plan and a paid parental leave program. RVO Health is an equal opportunity employer that does not discriminate against any employee or applicant because of race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or any other basis protected by law. Employment at RVO Health is based solely on a person's merit and qualifications.  We are committed to providing equal employment opportunities to qualified individuals with disabilities. This includes providing reasonable accommodation where appropriate. Should you require a reasonable accommodation to apply or participate in the job application or interview process, please contact accommodations@rvohealth.com.We do not provide visa sponsorship for this role at this time.#LI-remote</section><div class="content-conclusion">RVO Health Privacy Policy: <a href="https://nam10.safelinks.protection.outlook.com/?url=https%3A%2F%2Frvohealth.com%2Flegal%2Fprivacy&data=05%7C01%7Cbblankenship%40rvohealth.com%7C1510f53cf659471b999e08dabc259ced%7C00e1df3d9626410c898c16aaa8c2afc9%7C0%7C0%7C638029166974867871%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=uCauLbrBaYhsGWlQoABzOwOqqjDY5fX0dBvLv4Ob%2F44%3D&reserved=0">https://rvohealth.com/legal/privacy</a></div>

Associate Credentialing Specialist

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