Credentialing Coordinator
Teledoc
 Quincy, MA

Mission to our employees:

A mission-driven organization, Teladoc Health, Inc. is successfully transforming how people access and experience healthcare around the world. Through market-leading innovation in virtual care, our award-winning clinical solutions are helping millions of people resolve their healthcare needs with confidence. Today we have more than 2,000 employees, working together to deliver care in 130 countries and in more than 30 languages, to more than 10,000 clients including world recognized leaders.

We are committed to providing our Employees with a dynamic and collaborative work environment; there is equal opportunity for learning and personal growth. Creativity and innovation are encouraged. Above all, our mission-oriented employees will be treated with the same attention, respect, values and care that we provide to our clients and members.

What you are looking for:

The Credentialing Coordinator is responsible for credentialing provider files for the Teladoc Physicians, P.A. to ensure that only qualified practitioners provide care to Teladoc members. Under supervision of the Credentialing Manager, the responsibilities include, but not limited to, coordinating quality file review and approval, researching and obtaining verification of providers' medical experience, professional references, state licensure, Drug Enforcement Administration (DEA) registration, Board Certification, etc., and evaluating data and determining suitability per National Committee for Quality Assurance (NCQA) requirements and other governing regulatory bodies.

What you will do:

  • Responsible for timely processing of initial/reappointment applications for completeness
  • Completes primary source verification and credentialing in accordance with regulatory and NCQA accreditation standards and guidelines
  • Quality reviews and prepares documents related to credentialing and provider file audits
  • Respond to internal and external requests with utmost professional communication, timeliness, and focus on high-level of customer service.
  • Able to act independently to review and assess provider applications for completion, identify credentialing concerns, and request appropriate follow-up information from practitioner(s) or other sources as needed
  • Utilizes credentialing resources and other software as required
  • Maintain credentialing databases by ensuring data is entered accurately and in timely manner
  • Responsible for quality and integrity of provider files. Ensure files are maintained according to and all applicable governing agencies and internal quality and security policies, to include both paper and electronic document management
  • Adhere to all company policies, procedures, state, federal, and certification bodies such as, but not limited to NCQA, HIPAA, PHI, CAQH, CMS/Medicare, and Medicaid
  • Competent in all aspects of credentialing and flexible to support business needs within Provider Operations Department
  • Other duties as directed, including but not limited to recruiting, credentialing or physician relations.

What we are looking for:

  • Must possess strong time management, organizational skills, and be detail-oriented with a commitment to quality
  • Able to work independently
  • Analytical mindset, with focus on process improvement and customer service resolution
  • Able to maintain accuracy while meeting deadlines and production requirements
  • Ability to react professionally and maturely to unplanned circumstances, demands and challenges in a fast-paced environment
  • Working knowledge of NCQA, Medicaid and other regulatory requirements
  • Interact professionally and effectively with all levels of staff, leadership, providers, and clients

Requirements:

  • Two years of college required, degree in related field preferred
  • Two years of experience in healthcare credentialing preferred
  • Certified Provider Credentialing Specialist (CPCS) or other credentialing certification
  • Medicaid credentialing experience is highly desirable
  • Credentialing software experience preferred

Company Benefits:

  • Very competitive salary & equity compensation
  • Excellent health, dental, vision coverage
  • 401k benefits with employer matching contribution; immediately vested
  • Awesome people to work with
  • Becoming a part of a movement in telemedicine and building something that matters

At Teladoc Health we thrive on difference and individuality. Teladoc Health is proud to be an equal opportunity workplace and is an affirmative action employer. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status.