Credentialing Subject Matter Expert

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The HiLabs Story

The HiLabs Story
HiLabs is a leading provider of AI-powered solutions to clean dirty data, unlocking its hidden potential for healthcare transformation. HiLabs is committed to transforming the healthcare industry through innovation, collaboration, and a relentless focus on improving patient outcomes.
HiLabs Team

• Multidisciplinary industry leaders
• Healthcare domain experts
• AI/ML and data science experts
• Professionals hailing from the worlds best universities, business schools, and engineering institutes including Harvard, Yale, Carnegie Mellon, Duke, Georgia Tech, Indian Institute of Management (IIM), and Indian Institute of Technology (IIT).
  

About Hilabs: Hilabs is a leading provider of innovative healthcare solutions, specializing in diagnostic services, laboratory technology, and healthcare analytics. Our mission is to empower healthcare providers, payors, and patients with cutting-edge solutions that enhance decision-making, streamline operations, and improve health outcomes.
Job Title : Credentialing Subject Matter Expert

• Responsible for supporting the end-to-end payer/provider credentialing lifecycle
• Perform credentialing and re-credentialing activities according to plan specifications and in compliance with CMS/NCQA standards, which includes completing primary source verification, including:
• Education and Board verifications
• State Licenses
• Ensure credentialing files are being completed in a timely and accurate manner
• Reviewing credentialing files and marking them as ready to complete the credentialing process
  

Qualifications

• 3-5 years of credentialing experience in either a payer or provider organization.
• Strong knowledge of state-by-state licensing requirements
• Familiarity with delegated credentialing structures.
• Knowledge of NCQA, URAC, CMS, and state Departments of Insurance regulatory requirements.
• Experience implementing or improving credentialing systems and automation tools, including generating and distributing CACTUS reports.
• High attention to detail including effective communications at all organizational levels.
• Demonstrated organizational skills and ability to adhere to timelines and SLA metrics.
  

Why Join Hilabs?

• Competitive salary and performance-based incentives.
• Opportunity to work in an innovative, rapidly growing company at the forefront of healthcare solutions.
• Collaborative and dynamic work environment with opportunities for professional growth and advancement.
• Comprehensive benefits package, including health, dental, vision, and retirement options.
  

Hilabs is an equal-opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
HiLabs Total Rewards
Competitive Salary, Accelerated Incentive Policies, H1B sponsorship, Comprehensive benefits package that includes ESOPs, financial contribution for your ongoing professional and personal development, medical coverage for you and your loved ones, 401k, PTOs & a collaborative working environment, Smart mentorship, and highly qualified multidisciplinary, incredibly talented professionals from highly renowned and accredited medical schools, business schools, and engineering institutes.
CCPA disclosure notice -

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Software Development

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