Credentialing Team Lead
We operate on PST and candidates in any time zone are welcome to apply. We ask employees to travel to our San Jose, CA office up to three times per year plus one company-wide offsite, PSTFull-TimeLead
Salary55,000 - 75,000 USD per year
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Job Details
- Experience
- 3+ years of experience in healthcare credentialing, operations, or administrative support in a payer or provider setting; 1+ years experience supervising credentialing associates
- Required Skills
- Microsoft ExcelCRMGoogle Sheets
Requirements
- 3+ years of experience in healthcare credentialing, operations, or administrative support in a payer or provider setting.
- 1+ years experience supervising credentialing associates.
- Operational leadership and accountability.
- Strong understanding of NCQA credentialing requirements and best practices.
- Proficiency with Microsoft Excel/Google Sheets.
- Experience with CRM or credentialing software (e.g., CAQH, Verifable).
- Excellent organizational and communication skills.
- Experience in behavioral health or mental health provider credentialing.
Responsibilities
- Provide day-to-day guidance, training, and support to credentialing associates.
- Design, document, and implement scalable credentialing workflows and standard operating procedures (SOPs).
- Identify and troubleshoot inefficiencies in credentialing and recredentialing processes.
- Collaborate cross-functionally to ensure credentialing processes integrate smoothly with clinical, compliance, and billing teams.
- Manage relationship with CVO (Credentialing Verification Organization), Verifiable.
- Maintain accurate and up-to-date provider information in internal databases and Verifiable.
- Track application statuses, credentialing deadlines, and recredentialing timelines to ensure timely completion.
- Analyze and update processes to improve timelines.
- Liaise with CVO to resolve any issues or delays in the credentialing process.
- Develop and maintain dashboards, reports, and trackers related to provider credentialing and compliance.
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