OpenLoop Health is a healthcare technology startup whose services are used by companies that provide telehealth delivery across all 50 states. In past hiring, the award-winning hea
Credentialing Specialist
Location
United States
Posted
29 days ago
Salary
0
Seniority
Mid Level
No structured requirement data.
Job Description
Credentialing Specialist
OpenLoop Health
Role Description OpenLoop’s mission is to bring care anywhere by powering telehealth solutions at scale. The Credentialing Specialist is responsible for managing the credentialing and recredentialing processes for healthcare providers in accordance with our NCQA accredited Credentialing Verification Organization (CVO) guidelines. This role ensures all providers meet necessary qualifications and maintain compliance with industry standards, supporting the delivery of high-quality patient care. - Review and complete initial and renewal credentialing applications for healthcare providers across multiple practices, ensuring adherence to State, Federal, and NCQA CVO guidelines. - Verify provider credentials, including education, training, licensure, certifications, and work history. - Maintain and update credentialing documentation in the company’s credentialing database while ensuring records are accurate, complete, and up-to-date. - Monitor the status of credentialing applications and provider files, ensuring timely renewals and proactive follow-ups. - Track key credentialing metrics and generate reports on credentialing statuses and compliance. - Serve as a point of contact for providers regarding credentialing inquiries and communicate effectively with regulatory agencies and internal stakeholders. - Ensure all credentialing activities comply with state/federal regulations, board requirements, and NCQA standards. - Collaborate with legal and regulatory teams to stay informed about changes in requirements and implement necessary adjustments. - Identify and resolve issues or discrepancies in credentialing documents and manage communications with accrediting bodies for escalated issues. - Proactively identify opportunities to enhance the credentialing process and stay updated on industry trends. - Assist with preparing reports and presentations related to credentialing activities. - Other duties as assigned. Qualifications - 1-2 years of experience in healthcare credentialing, regulatory compliance, or a related field. - Experience with provider data management systems such as MDStaff. - Familiarity with NCQA CVO guidelines and multi-state credentialing processes is highly desirable. - Proficiency in using credentialing software and E-Ticketing systems (e.g., Jira, Zoho Desk) is a plus. - Detail-oriented with strong organizational and time-management skills. - Excellent communication skills, both written and verbal, for effective interaction with providers and regulatory bodies. - Strong analytical and problem-solving abilities. - Ability to work independently and collaboratively within a team environment. - Commitment to maintaining confidentiality and adhering to ethical standards in handling provider information. Preferred Qualifications - Certification in Credentialing (e.g., Certified Provider Credentialing Specialist) is advantageous. - Experience working within an NCQA-accredited CVO or similar credentialing organization. Benefits - Medical, Dental, and Vision plans - Flexible Spending/Health Savings Accounts - Flexible PTO - 401(k) + Company Match - Life Insurance, Pet insurance, and more Company Description We have a relatively flat organizational structure here at OpenLoop. Everyone is encouraged to bring ideas to the table and make things happen. This fits in well with our core values of Autonomy, Competence and Belonging, as we want everyone to feel empowered and supported to do their best work.
Related Guides
Related Categories
Related Job Pages
More Billing Specialist Jobs
Senior SEO/Website Specialist
Dental Media CorpEmpowering dental professionals with cutting-edge media solutions to grow their practices and connect with patients.
Role Description We’re looking for a Senior SEO Specialist to lead strategy and execution across multiple client accounts. You’ll be responsible for creating and implementing SEO campaigns that drive measurable results. This role is hands-on and requires both technical expertise and strategic thinking. Qualifications - 3+ years proven SEO experience - Agency experience is a strong plus - Strong knowledge of on-page, off-page, and technical SEO - Strong proficiency with Ahrefs - Experience with GA4, Google Search Console, SEMrush, and Screaming Frog - Comfortable using Claude and AI tools as part of the SEO workflow - Analytical mindset with the ability to turn data into strategy - Excellent communication skills - Clear, fluent spoken English is required - Client-facing experience is a strong plus Requirements - You must have clear, fluent spoken English. - You must be highly proficient with Ahrefs. - You must be comfortable using Claude and AI tools to improve SEO workflows. Benefits - Competitive, negotiable salary based on experience and results - Remote work flexibility - Work on diverse industries and exciting projects - Be part of a small, ambitious team where your work has a real impact - Growth opportunities as we expand
Specialist, Bank Identified Fraud Intake
First National Bank of OmahaA subsidiary of First National Bank of Nebraska, First National Bank of Omaha is a sixth generation family-owned business and the biggest privately held bank in
Title: Specialist, Bank Identified Fraud Intake - $20/HR (Omaha, NE Only) Location: Omaha, Nebraska, USA- FN Tower Remote after training and 90 probationary period Job Description: At FNBO, our employees are the heart of our story—and we’re committed to their success! Please see below the details of this career opportunity and how it fits into our organization’s success. Summary of the Job: At FNBO, we believe that a bank should be a force for good in the world. And to us, that means doing right by our customers, our employees and our communities day in and day out. As a Fraud Specialist, you can do just that by helping FNBO customers protect themselves against fraud as well as providing excellent customer service. We are looking for someone who will share our excitement about the opportunity to handle inbound fraud phone calls and immerse yourself in the world of fraud. Our mission is to support our customers who have been victims of fraud by obtaining details of the fraud. This environment is fast paced, and each case is different therefore initiative, customer focus and adaptability are all important skills to be successful in this role. This role is critical to meeting the needs of our customers. You will be required to adhere to the schedule provided to ensure proper coverage for our business needs. Regular and predictable attendance is also required. Training: Training will take place onsite for a duration of six (6) weeks at the FNBO Omaha Tower, located at 1601 Dodge Street, Omaha, NE 68102. The training schedule is Monday through Friday, from 8:00 a.m. to 5:00 p.m. (6/8/26 to 7/17/26) Schedules: After successfully completing training, employees will enter a 90 probationary period. During this time, performance goals must be met in order to qualify for remote work eligibility. Upon meeting the required goals, employees may transition to a remote work arrangement. PERMANENT SCHEDULE BEGINS MONDAY 7/20/26 AVAILABLE SCHEDULES: Mon, Tue, Wed, Thur, Sun 05:00 AM - 02:00 PM [60min Lunch] Mon, Tue, Fri, Sat 06:30 AM - 05:30 PM [60min Lunch] Mon, Tue, Fri, Sat 06:30 AM - 05:30 PM [60min Lunch] Mon, Tue, Fri, Sat 07:00 AM - 06:00 PM [60min Lunch] Mon, Tue, Fri, Sat 07:00 AM - 06:00 PM [60min Lunch] Mon, Tue, Fri, Sat 12:00 PM - 11:00 PM [60min Lunch] Mon, Wed, Thurs, Sun 08:00 AM - 07:00 PM [60min Lunch] Mon, Wed, Thurs, Sun 08:00 AM - 07:00 PM [60min Lunch] Mon, Tue, Wed, Fri 09:00 AM - 08:00 PM [60min Lunch] Mon, Wed, Thurs, Sun 09:00 AM - 08:00 PM [60min Lunch] Mon, Thurs, Fri, Sun 09:00 AM - 08:00 PM [60min Lunch] Mon, Tue, Wed, Thur, Sun 10:00 AM - 07:00 PM [60min Lunch] Mon, Wed, Thurs, Sun 12:00 PM - 11:00 PM [60min Lunch] Wed, Thurs, Fri, Sat 08:00 PM - 06:30 AM [30min Lunch] *** Please note that set schedule preference selections will be considered in the order in which they are received, and that selecting a shift/schedule does not guarantee you these hours, as offers are not finalized until you have spoken with a FNBO Talent Advisor.*** Schedule Commitment Policy: When you accept a new shift, we ask that you remain on that shift for (6) months. This helps us maintain consistency for both our team and the individuals we serve. About This Role: THE SPECIFICS: As a Fraud Specialist at FNBO, you will be expected to: - Create fraud case files to continuously meet or exceed department standards of quality and productivity. - Work independently with customers over the phone to answer and/or ask questions regarding their disputed transactions on both Debit and Credit Card accounts. - Follow Association and Federal regulations when entering a case and adhere to department standards for accuracy and productivity. - Meet customer’s needs by recognizing different communication styles and adjusting your communication accordingly. - Demonstrate professional behavior and promote positive working relationships. - Provide information in concise and logical ways. - Fully engaged in team communication and, on occasion, be willing to provide guidance to team as appropriate. - Adhere to FNBO’s attendance guidelines by having regular and predictable attendance. Regulatory/Compliance: Understand and comply with the Bank's BSA/AML Program, which includes, but is not limited to the following: - Understand and comply with bank policy, laws, regulations, and the bank's BSA/AML Program, as applicable to your job duties. - Complete compliance training and adhere to internal procedures and controls, as required. - Report any known violations of compliance policy, laws, or regulation and any suspicious customer and/or account activity. In this department, we wouldn’t call our jobs easy, but we would call them rewarding. If you are a strategic problem solver who enjoys a challenge with a rewarding payoff, join us. We will provide the support and training to help you become a well-versed Specialist who can make a big difference to our customers’ financial lives. The Ideal Candidate for This Role: THE IDEAL CANDIDATE FOR THIS ROLE IS… - Focus on attention to detail and accuracy. - Ability to multi-task while using dual monitors and multiple systems to gather information. - Excellent oral and written communication, typing and reading comprehension skills. - Team oriented, yet able to work independently in a diverse fast-paced, deadline-driven environment. - Ability to solve problems and take ownership of work. - Proven decision-making and organizational skills. EXPERIENCE AND BACKGROUND REQUIREMENTS Required: - High School diploma and/or equivalent experience. - Previous customer service experience. - Working knowledge of Microsoft Office suite of products. Desired: - Previous experience in a remote working environment - Previous contact/call center experience - Previous banking experience. - Bilingual (English/Spanish) - Potential to earn 10% Language Differential PERKS AND BENEFITS - Competitive pay and benefits - Remote work opportunities - A supportive environment with ongoing support and training - Tuition Assistance after 1 year of service Candidates must possess unrestricted work authorization and not require future sponsorship. Work Environment: It is anticipated that the incumbent in this role will work onsite at the posted location. Our onsite environment fosters innovation, mentorship, and a vibrant culture where ideas flow freely and relationships flourish. As part of our team, you'll experience the energy of our collaborative spaces designed to support your professional growth while working alongside talented colleagues who inspire excellence daily. Please note that work location is subject to change based on business needs. Compensation and Benefits Overview: We offer a variety of benefits designed to keep you and your family physically and financially healthy. Not only do we offer a competitive salary and work-life balance, we offer benefits to match your needs: - Medical, Dental, Vision Insurance - 401k, With Matching Contributions - Time Off Programs - Health Savings Account (HSA)/Dependent Care - Employee Banking - Growth Opportunities - Tuition Assistance - Short-Term/Long-Term Disability Insurance Learn more about FNBO benefits here: https://www.fnbo.com/careers/benefits/. To obtain compensation and benefit information related to this specific role, e-mail FNBO at TAGAdmin@fnni.com. To ensure you receive a response, include the number of this job (listed below) in the subject line of your message. Equal Opportunity & Belonging: FNBO believes that the quality of our employee experience is at the heart of our customer experience. One key pillar of our intended employee experience is Belonging. Belonging means we are committed to fostering a workplace culture where employees of all backgrounds feel valued, recognized, and empowered to be their authentic selves—no matter their role or where they are in their journey. FNBO is an equal opportunity employer for all employees and applicants and makes employment decisions without regard to status or identity.
Role Description Skills on the Hill is a pediatric therapy practice with locations in Washington, D.C. and Arlington, VA that specializes in supporting and empowering children and families to climb to their fullest potential. We are seeking a Billing Coordinator to work as a part of our stellar administrative team, specifically our Revenue Cycle Manager, Benefits Assistant, and our On-Site Team (Administrative Manager and Office Coordinators). This is not a "post claims and clock out" job. We're looking for one person — a real one — who knows that great billing is part detective work, part diplomacy, and part stubborn refusal to let dollars slip through the cracks. If chasing down a payer for the third time makes you smile because you know you're going to win, keep reading. Qualifications - Excellent written and verbal communication - Demonstrated track record in remote work (or strong evidence you can self-manage without a manager hovering) - Comfort across multiple systems — EMRs, payer portals, Excel, communication tools - Attention to detail you can prove with real examples - The follow-up grit we keep talking about Requirements - Medical billing experience, especially in pediatric PT, OT, or speech-language pathology (strongly preferred) - Familiarity with practice management software (we use Practice Pro — we'll teach it; what we can't teach is hustle) - Experience with insurance verifications, EOB posting, secondary billing, and AR follow-up - Associate's or bachelor's degree in healthcare administration, business, or related field (strongly preferred) - High school diploma or equivalent required Benefits - Medical, dental, and vision insurance - Short- and long-term disability coverage - Company-paid life insurance - 401(k) with company contribution - Paid time off - Company-provided computer and tech setup - Continuing education stipend to keep your billing and coding knowledge sharp
Insurance Billing/Collection Assistant II – Business Office
WashU ITWashington University in St. Louis Information Technology
• Perform follow-up on insurance billing and collection activities • Verify the accuracy and completeness of insurance records and claims • Contact insurance companies to expedite payments from various payers for physician services • Review patient accounts to ensure timely and accurate payment of physician charges • Utilize Epic, system tools, and payer websites for claim submission and inquiry • Meet Quality Assurance and efficiency standards each day • Interact with management and staff members to discuss issues • Perform other duties as assigned by the supervisor and/or manager



