Credentialing Specialist

About the Role

The Credentialing Specialist is a volume‑driven, production‑based role that handles day‑to‑day activities involved in running a health insurance company, including provider interactions and back‑office credentialing tasks in accordance with standard operating procedures. You will report to the Manager, Provider Credentialing. This is a remote position open to candidates who reside in Arizona, Florida, Georgia, or Texas.

Responsibilities

• Develop a comprehensive understanding of current credentialing processes, procedures, and tools.
• Interact daily with providers or internal Oscar teams according to assignment needs.
• Manage an assigned caseload while maintaining service delivery, productivity, and quality expectations.
• Form working relationships with internal and external stakeholders.
• Support the leadership team by identifying issues through established escalation pathways.
• Monitor and track the health of all assigned work‑in‑progress issues.
• Escalate and resolve issues to ensure appropriate turnaround times.
• Participate actively in process improvement initiatives.
• Comply with all operational, regulatory, and compliance standards relating to member Personal Health Information (PHI).
• Comply with all applicable laws and regulations.
• Other duties as assigned.

Requirements

• High school diploma or GED.
• 1+ years of experience in a fast‑paced, volume‑based or customer‑service‑oriented environment.
• Strong verbal and written communication skills.
• Strong quantitative or analytical skills focused on proactively identifying or solving problems.
• In‑depth knowledge of health‑insurance credentialing or provider‑facing experience.
• Experience manipulating and entering accurate data in a production‑driven environment.
• Advanced Google Suite or Microsoft Office capabilities, or willingness to learn.

Pay

The base pay for this role is $19 per hour. Final offer amounts are determined by factors including relevant skills, education, and experience.

Benefits

• Medical, dental, and vision coverage.
• 11 paid holidays.
• Paid sick time.
• Paid parental leave.
• 401(k) plan participation.
• Life and disability insurance.
• Paid wellness time and reimbursements.
• Monthly vacation accrual at a rate of 15 days per year.