Medical Staff Services Specialist

Summary

Join Valera Health, a leader in tele-mental health, as a Medical Staff Services Specialist! This role ensures swift and accurate operations for provider onboarding, credentialing, and regulatory compliance. You will apply for and monitor provider licenses, verify requirements, and support the compliance team. Experience with licensing platforms and credentialing processes is essential. The position offers competitive pay ($24-$26/hr with potential bonuses) and benefits including health, vision, dental insurance; 401k; paid time off; short-term disability; and life insurance. Valera Health values diversity and is an equal opportunity employer.

Requirements

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

Responsibilities

• Apply for provider licenses in collaboration with the provider
• Monitor submitted license applications to determine status weekly
• Ensure all license applications are full and complete to streamline processing time
• Verify providers’ requirements for approval to work in specific states and plans
• Experience with licensing platforms, i.e IMLC, eNLC, state board websites
• Supporting the compliance team with periodic reviews of NCQA policies
• CAQH ongoing maintenance/management
• Resolve license deficiencies and related issues within state board requirements
• Assist in interpreting state requirements and communicate with state licensing boards as necessary
• Advanced skills in Excel and Google Sheets
• Familiar with Internal and External credentialing process
• Maintains strict confidentiality of all provider files
• Other duties as assigned
• Ensure strict HIPAA-compliant confidentiality with all healthcare-related data
• Set up and manage provider information in the provider data platform
• Resolves any deficiencies with credentialing or licensing in compliance with regulatory requirements
• Processes applications (initial and reappointment) for credentials for Valera providers by obtaining and analyzing primary source verification information and identifying deficiencies in records as outlined in the bylaws in accordance with credentialing requirements of NCQA
• Establishes, updates, and maintains credentialing files for every provider in employment. Ensures compliance with state, federal, and accrediting agency requirements
• Maintains the Medical Staff electronic database. Second set of eyes for all verification tracking and maintenance
• Maintains CMS I&A requests and approvals
• Assist with completing delegated health plan monthly rosters
• Assist in training new team members

Benefits

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