Job description
Are you looking for a career that aligns your passion and values with your purpose? Then we are looking for you!
At Valera Health we are at the forefront of tele-mental health. We are committed to delivering compassionate mental health care that is accessible and affordable to all. To learn more about Valera, check us out HERE.
Watch to learn more about Valera Health here!
About You:
The mission of the Medical Staff Services Specialist is to enable swift, accurate, and comprehensive operations to execute upon Valera’s goals for provider onboarding, credentialing, and regulatory compliance.
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.
Additional Provider MSS Specialist responsibilities
- 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.
Qualifications:
- 1-2 years of credentialing experience
- Have worked in a remote setting before
Fair work deserves fair wages. At Valera, we value this role at between $24-$26/hr.
Eligible Employee Benefits include but not limited to:
- Health, Vision & Dental Insurance
- 401k through the Standard
- Paid Time Off
- Short Term Disability
- Life Insurance
- Office Equipment
- Many more
Be part of our mission!
We are very proud of the work that we do and it takes a great team to make it happen! If you are interested in one of our open positions, we’d love to start the conversation.
We hire people from all backgrounds because that’s what it takes to build a team that can reach and support those in need of high-quality behavioral healthcare. We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, national origin, disability status, protected veteran status, or any other characteristic protected by law.
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