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About Certify
Certify is a leading provider of healthcare data infrastructure solutions, empowering the next generation of provider data products to make healthcare more efficient, accessible, and innovative. Our platform is the ultimate source of truth for provider data, offering unparalleled ease and trust while making data easily accessible and actionable for the entire healthcare ecosystem.
What sets us apart?
Our cutting-edge, API-first, UI-agnostic, end-to-end provider network management platform automates licensing, enrollment, credentialing, and network monitoring like never before. With direct integrations into hundreds of primary sources, we have an unbeatable advantage in enhancing visibility into the entire provider network management process. Plus, our team brings over 25+ years of combined experience building provider data systems at Oscar Health, and we're backed by top-tier VC firms who share our bold vision of creating a one-of-a-kind healthcare cloud that eliminates friction surrounding provider data.
About the role
We are seeking a highly skilled Quality Assurance Specialist to join our core credentialing team. As an early employee, you will play an integral part in ensuring the timely and accurate credentialing of healthcare professionals per company, regulatory, and client requirements. This is a fully remote role and will report to the Associate Director of Credentialing.
Key Responsibilities:
- Develop and implement a comprehensive, effective, and efficient audit process
- Conduct initial and ongoing quality audits for credentialing applications
- Perform audit reviews in a timely, efficient, and accurate manner
- Provide constructive feedback and education to peers and assigned teams
- Utilize audit results to identify, document, test the effectiveness of internal processes and controls, and develop sound conclusions
- Track and trend audit results and notify leadership to administer appropriate team members' education and coaching
Requirements:
- 2+ years of experience in credentialing, provider data management, auditing, or healthcare operations
- 1 year of credentialing auditing experience or similar
- Professional written and verbal communication skills
- Close attention to detail and ability to use audit process techniques
- Knowledge of NCQA credentialing standards preferred
About Certify's Culture
Certify is committed to creating an inclusive workplace where everyone feels valued and supported. As an equal opportunity employer, we celebrate diversity and warmly invite applicants from all backgrounds to join our vibrant community.
