Medical Staff Services Specialist

Summary

Join Valera Health, a leader in tele-mental health, and contribute to our mission of providing accessible and affordable mental healthcare. This role focuses on provider onboarding, credentialing, and regulatory compliance, ensuring swift and accurate operations. You will guide new providers through onboarding, manage documentation, verify eligibility, maintain credentialing files, and process applications according to NCQA and regulatory standards. Responsibilities include preparing reports, maintaining databases, monitoring license expirations, ensuring compliance, and assisting with team training. The position offers competitive pay ($24-$26/hr with potential bonuses) and benefits including health, vision, and dental insurance; 401k; paid time off; short-term disability; and life insurance.

Requirements

• 1-2 years of credentialing experience
• Have worked in a remote setting before

Responsibilities

• Meet with newly onboarded providers to guide them through onboarding requirements and ensure timely completion
• Manage and review onboarding documentation and enter provider data into the provider platform
• Verify provider eligibility for working in specific states and health plans
• Maintain ongoing CAQH management and provider credentialing files
• Process initial and reappointment credentialing applications, including primary source verification and deficiency resolution, in accordance with NCQA and regulatory standards
• Prepare and submit credentialing and recredentialing reports and delegated rosters to health plans
• Maintain the Medical Staff electronic database and track all credentialing verifications
• Monitor and notify providers of upcoming license expirations and required renewals
• Maintain CMS I&A requests and approvals
• Ensure full compliance with NCQA, CMS, HIPAA, and all applicable state and federal regulations
• Notify appropriate staff when providers are fully onboarded and credentialed
• Assist in training new team members
• Maintain strict confidentiality of all provider information
• Perform other duties as assigned

Benefits

• Health, Vision & Dental Insurance
• 401k through the Standard
• Paid Time Off
• Short Term Disability
• Life Insurance
• Office Equipment