Credentialing Specialist

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🔥 0 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $58.7k - $80.3k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

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VSP Vision Care

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1955

🏥 Healthcare

📣 Marketing

🍽️ Food & Beverage

Healthcare • Marketing • Food & Beverage

VSP Vision Care is a leading eye care company that focuses on providing access to quality eye care and eyewear solutions. With a comprehensive portfolio of services, VSP Vision Care supports both individuals seeking eye health services and providers managing their practices. The company is committed to social responsibility, emphasizing health equity, sustainability, and a culture of belonging. Through initiatives such as Follow Your Heart, VSP Vision Care helps people maximize the value of their offerings, starting with eyewear. Recognized for its customer service excellence and commitment to diversity and inclusion, VSP Vision Care strives to empower human potential through sight. It has also been acknowledged as a top workplace in healthcare and is committed to supporting veterans and the military-connected community.

📋 Description

• Develop and cultivate productive relationships with providers, retail chains, strategic partners, and their staff • Educate providers on industry-standard credentialing requirements using team knowledge and resources • Establish provider relationships to obtain regulatory information and manage initial and ongoing credentialing requirements • Ensure documentation complies with applicable state regulations • Oversee assigned files in the CVO partner’s system • Track credentialing files and collect missing documents to complete the process for new and existing providers • Research, analyze, and resolve complex credentialing issues and escalations • Coordinate with internal and external business partners to meet regulatory compliance requirements • Collect, evaluate, and compile information from regulatory reporting agencies, legal documents, and providers regarding sanctions and malpractice claims • Prepare information for the Credentialing Committee to support decisions on provider applications • Enter and maintain provider data while ensuring information integrity • Escalate issues and drive solutions when applicable • Gather provider information for the legal department to support the Dispute Resolution Process • Compose professional correspondence to providers, retail chains, and office staff • Act as an internal resource for business partners • Apply knowledge of the organization’s strategic direction to support growth and operational goals

🎯 Requirements

• Bachelor’s degree in a related field; 4 years of functional experience may substitute for the degree • Professionalism and leadership when handling controversy and conflict • Experience handling and resolving escalated issues • Advanced communication, influencing, and problem-solving skills • Experience working directly with providers and staff on credentialing policies and procedures • Ability to exercise discretion and independent judgment • Ability to identify problems and provide creative solutions • Strong attention to detail, multitasking, organizational, and customer service skills • Ability to balance provider needs with corporate objectives • Ability to work independently and in a team environment

🏖️ Benefits

• Eligible bonuses and commissions may be included as part of the compensation package • Equal opportunity employer • Drug-free workplace • Pre-employment substance abuse testing