Quality Assurance Auditor - Credentialing

About Certify:

At CertifyOS, we're building the infrastructure that powers the next generation of provider data products, making 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.

But it's not just about the technology; it's about the people behind it. At Certify, we foster a meritocratic environment where every voice is heard, valued, and celebrated. We're founded on the principles of trust, transparency, and accountability, and we're not afraid to challenge the status quo at every turn. We're looking for purpose-driven individuals like you to join us on this exhilarating ride as we redefine healthcare data infrastructure.

About the role:

We are looking for our next core credentialing team member! You will play an integral part in ensuring the timely and accurate credentialing of healthcare professionals per company, regulatory, and client requirements.As an early employee, you will have significant responsibility in helping to build infrastructure for a growing team. This is a fully remote role and will report to the Associate Director of Credentialing.

• Build a comprehensive, effective and efficient audit process
• Complete 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.

• 2+ years of credentialing, provider data management, auditing or healthcare operations experience
• 1 year 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

At Certify, we're 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.