Credentialing Specialist

At Talkspace, we are committed to fostering a diverse, equitable, inclusive, and belonging-centered workplace where everyone can thrive while making a difference in mental health. Want to help over two million people receive quality mental healthcare? Come join our mission of getting therapy in the hands of everyone!

We are looking for an experienced Credentialing Specialist to join our Credentialing (Clinical Quality Operations) team. This role would be responsible for executing and supporting the day-to-day credentialing operations, which includes collaborating with the Credentialing Manager to streamline operational processes...

This is a remote position required to work 9a-6p Monday - Friday local time. Talkspace Headquarters is located in NYC but we do not require residence in New York.

Credentialing
Exhibit wide-ranging experience and proficiency in performing all daily credentialing functions
Review and conduct quality check of all daily functions, such as review of completed files, approval dates, license expiration dates, provider credentialing data
Monitor provider status of credentialing files and communicate status updates to Credentialing Verification Organization (CVO)
Manage data entry and accuracy for all necessary provider information such as NPI numbers and/or CAQH profile information to ensure accurate storage record of provider files
Correspond with providers to via Zendesk
Coordinate with CVO and providers to ensure timely completion and maintenance of all credentialing correspondence and documentation in the Fountain system and implement Fountain system updates to reflect decisions in support of the Credentialing Manager

Recredentialing
Ensure timely re-credentialing of the credentialed provider network by performing weekly follow-up review of provider CAQH status and communicating status to CVO when complete or the provider when incomplete
Coordinate with CVO to ensure timely completion of re-credentialing review for each clinician
Maintain CVO database and files management within Fountain to aid with the completion of recredentialing
Performing quality assurance (QA) checks to ensure the uploaded documents in the Fountain system represent accurate data for each clinician
Assist Credentialing Manager with outreach and retention in high need states for providers in jeopardy of failing to re-credential and remain in the TS network
Assist Credentialing Manager as needed with completing duties related to the approved re-credentialed providers process
Ensure accurate status for approved and re-credentialed providers in the Fountain system

Auditing
Assist with quarterly internal audits to ensure efficiency and accuracy within the Credentialing Program using the audit tool
Assist with annual external CVO audits to ensure compliance with the delegated credentialing agreement using the audit tool
Work with Credentialing Manager and Enterprise clients to provide data for audits on an annual, monthly or ad hoc basis

Licensing
Perform quality review of credentialed license data to ensure accuracy
Initiate outreach of providers with expired license data to secure license renewal and retain providers in the state directory for the license in facilitating client transfer and/or deactivation with untimely license renewal

Relations Management
Maintain relationship with Enterprise clients under the delegated credentialing agreement as support to the Credentialing Manager

Performs other related duties as assigned.

2-3 years of professional work experience in a highly communicative role.
Bachelor’s Degree preferred.
Proficiency in Microsoft or like applications
Proficiency with G-Suite or like applications
Credentialing experience preferred.