Global Credentialing Specialist

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ComPsych

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1984

⚕️ Healthcare Insurance

🧘 Wellness

🤝 B2B

Healthcare Insurance • Wellness • B2B

ComPsych is a leading provider of employee assistance programs (EAP), offering mental health and wellness services to employees and their families. The company focuses on improving workplace productivity by providing support services that help employees manage personal and work-related challenges. ComPsych's solutions include counseling, crisis intervention, and various wellness programs designed to enhance overall employee satisfaction and performance.

📋 Description

• Review and analyze credentialing, re-credentialing, and provider qualification files submitted to ComPsych against required criteria to determine eligibility for and compliance within the network, within designated timeframes. • Verify provider credentials, licenses, certifications, education, and professional qualifications in accordance with country specific requirements and ComPsych standards. • Conduct primary source verification and regulatory checks, where applicable, to support provider onboarding and ongoing network participation. • Evaluate international provider qualifications and supporting documentation to ensure alignment with company, client, and local market requirements. • Contact providers (via phone or email) to request missing or incomplete information. • Identify and route “red flag” files for further review and resolution. • Perform required queries on designated providers, obtain written reports, and review for incidents within set timelines. • Maintain performance targets, including processing initial applications and re-credentialing files (“red-reds”) each day. • Properly document notes and decisions in CPP (Credentialing Processing Platform) to support determinations on provider files. • Maintain accurate provider records and documentation within credentialing systems and databases, including required data entry. • Collaborate with internal stakeholders regarding provider eligibility, credentialing exceptions, and compliance requirements for global provider networks. • Log into all required systems, including the call queue, on your assigned rotation day and throughout your work shift, ensuring calls are answered promptly. • Respond to all messages in the inbox on assigned rotation day for timely responses to internal and external customers/providers. • Escalate any concerns, client or customer issues, or delayed matters to your Team Lead for support and resolution. • Perform other duties as assigned.

🎯 Requirements

• Bachelor's degree required. • Experience working with provider credentialing, licensing, compliance, or healthcare operations required; experience within the mental health or broader healthcare industry strongly preferred. • Knowledge of international healthcare credentials, licensing requirements, or provider network operations preferred. • Ability to interpret and evaluate professional qualifications from multiple countries and regulatory environments. • Ability to multi-task; great organization skills. • Strong attention to detail and follow-up skills. • Self-starter with ability to multi-task and work autonomously. • Excellent organizational and project management skills. • Effective interpersonal and communication skills, with the ability to communicate professionally across cultures and time zones.

🏖️ Benefits

• Statutory paid leave and public holidays. • Employer-sponsored health and social insurance contributions (where applicable). • Employee wellbeing programs. • Access to Employee Assistance Programs (EAP)