Specialist, Credentialing (Privileging)

About Medallion Healthcare is going through an unprecedented transformation towards digital care. Medallion provides the critical administrative infrastructure to make that change possible. Our platform enables organizations to license their providers in new states, verify existing credentials, and get in-network with health plans. In just over three years, our platform has become an industry standard powering hundreds of healthcare companies to reduce administrative burden for tens of thousands of providers across the country. To date, Medallion has saved over 500,000 administrative hours for our customers! As one of the fastest-growing healthcare technology companies—ranked No. 3 on Inc. Magazine’s 2024 Fastest-Growing Private Companies in the Pacific Region, No. 5 on LinkedIn's 2024 Top Startups in the US, a Glassdoor Best Place to Work in 2024 & 2025, and featured on The Today Show—Medallion is revolutionizing provider network management. Our CEO, Derek Lo, has been named one of the Top 50 Healthcare Technology CEOs of 2024 by The Healthcare Technology Report. Backed by $85M in funding from world-class investors like Sequoia Capital, Google Ventures, Optum Ventures, and Salesforce Ventures, we’re on a mission to transform healthcare at scale. About the role As Medallion’s Credentialing-Privileging Specialist, you will play a crucial role within our Privileging team. Our Privileging Team is core to our business and is responsible for ensuring that providers are credentialed and privileged efficiently and accurately. We're looking for optimistic self-starters who excel both independently and in team environments. If you’re passionate about privileging multiple provider types and eager to help improve our processes, we’d love to hear from you! Compensation for this role is between $19 - $27 depending on location and level. What you'll do • Collaborate with Medical Staff Offices to facilitate provider privileging processes. • Conduct comprehensive verifications of provider history, including: •

• Work History (Employment): Verify where the provider worked, whether directly at a hospital or through a provider group.

• Hospital Affiliation: Confirm privileges to practice and provide care at specific hospitals. • Claims History: Ensure the provider's claims history aligns with credentialing requirements. • Education and Licensure: Verify all degrees, certifications, and licenses, adhering to timeframe requirements (e.g., 5 years, 10 years, or entirety of history as applicable). • Differentiate and align work history (employment) with hospital affiliation to ensure accurate representation of provider practice and privileges. • Perform 10-year (or specified timeframe) primary source verification (PSV) processes for hospital affiliation, work history, education, claims history, and licensure. • Pre-fill hospital privileging applications with verified provider information, ensuring accuracy in work history, hospital affiliations, licensure, and any additional requirements specified by the hospital. • Review, manage, and submit Delineation of Privileges (DOP) forms for providers. • Handle inquiries from hospital privileges committees and resolve discrepancies in provider history or documentation. • Work with various provider types, including physicians and advanced practitioners, to ensure accurate and complete privileging. • Maintain detailed records of correspondence and verifications during the privileging process. • Communicate clear instructions and be responsive to providers in a timely and professional manner • Resolve issues that involve people, things, and processes by using logic, collaboration and critical thinking • Other duties as assigned Qualifications • Proven experience in privileging providers, with expertise in verifying hospital affiliations, work history, education, licensure, and claims history. • Clear understanding of the distinction between hospital affiliation and work history (employment): •

• Work History: The provider's employment, whether directly at the hospital or through a group.

• Hospital Affiliation: The provider's privileges to practice at specific hospitals. • Ability to pre-fill hospital privileging applications, including Delineation of Privileges (DOP) forms, ensuring all necessary details are accurately completed according to hospital-specific requirements. • Experience conducting primary source verifications (PSV) for various aspects of provider history and aligning them across records. • Familiarity with timeframe requirements (e.g., 5 years, 10 years, or entirety of history) for different types of verifications. • Exceptional problem-solving skills to address issues during the verification process or raised by hospital medical staff offices • Strong organizational and communication skills to ensure accurate documentation and effective collaboration. • Conduct yourself in a professional manner when interacting with providers and Medallion clients • Familiarity with multiple provider types is a bonus • Expertise in using GSuites tools include GSheets, GDocs, and GMail Apply Job!