Medical Staff Services Specialist

Employment Type: [Not Specified] Location Type: [Not Specified] Salary: $24-$26/hr with the potential for an annual performance bonus.

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:

Provider Licensing:

• 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.
• Resolve license deficiencies and related issues within state board requirements.
• Assist in interpreting state requirements and communicate with state licensing boards as necessary.

Compliance and CAQH:

• Supporting the compliance team with periodic reviews of NCQA policies.
• CAQH ongoing maintenance/management.

General Responsibilities:

• Maintains strict confidentiality of all provider files.
• Ensures 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.
• Other duties as assigned.

Qualifications:

• 1-2 years of credentialing experience.
• Have worked in a remote setting before.
• Advanced skills in Excel and Google Sheets.
• Familiar with Internal and External credentialing process.

Employee Benefits:

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

Company Information:

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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