Position Title: CVO Documentation & Audit Specialist
Department: Credentialing Operations
Reports To: Director of Credentialing / VP of Operations
Location: Remote — Philippines
Employment Type: Full-time
Target Start Date: March 1, 2025
Position SummaryThe CVO Documentation & Audit Specialist will lead the preparation, documentation, and compliance efforts required for NCQA CVO Certification. This is a critical hire for an accelerated certification timeline targeting Q3 2025. The role involves developing and maintaining credentialing policies and procedures aligned with NCQA standards, conducting internal audits, preparing documentation for survey submission, and ensuring ongoing compliance with certification requirements.
Key Responsibilities- NCQA Documentation & Compliance (50%)
- Develop, write, and maintain credentialing policies and procedures aligned with NCQA CVO standards
- Cross-reference all policies and procedures to specific NCQA standards and elements
- Prepare and organize documentation for Interactive Review Tool (IRT) submission
- Track and monitor NCQA policy updates, corrections, and clarifications
- Quality Improvement & Audit (30%)
- Establish and maintain quality improvement (QI) processes as required by NCQA
- Conduct internal file audits (10-20% of closed files) to ensure compliance
- Prepare mock survey materials and conduct internal readiness assessments
- Collect and analyze QI metrics and prepare reports for certification review
- Survey Preparation & Support (20%)
- Coordinate survey submission timeline and requirements
- Prepare file samples for NCQA surveyor review
- Support virtual survey logistics and documentation requests
- Address surveyor findings and coordinate corrective action responses
- 4-6 years of experience in healthcare credentialing or CVO operations
- Direct experience with NCQA credentialing standards (CVO or CR) — REQUIRED
- Experience preparing for and/or participating in NCQA surveys or health plan audits
- Strong policy and procedure writing skills
- Proficiency with credentialing software (CAQH, VerityStream, Cactus, or similar)
- Excellent English written and verbal communication
- CPCS (Certified Provider Credentialing Specialist) or CPMSM certification from NAMSS
- Experience with delegated credentialing arrangements
- Prior work at an NCQA-certified CVO
- Familiarity with JCAHO, CMS, and state credentialing requirements
Top Skills
What We Do
Optimizing Healthcare Organizations through Revenue & Cost Transformation Neolytix is a Management Service Organization (MSO) serving independent healthcare providers. Neolytix has been working with healthcare practices for the last 11 years and providing a helping hand for busy medical practitioners. Our services have helped increase monthly collections, create efficient processes for office administration, improved patient experience and free up physician time for providing better care. We provide shared services solutions for Medical Offices supporting Revenue Cycle Management, Credentialing, Virtual Assistants, IT Support, Practice Marketing with guaranteed impact on the overall bottom line. That means better service for a lower cost. #MedicalBilling #RPM #MSO #medicalbilling #remotepatientmonitoring #valuebasedcare #revenuecyclemanagement #Healthcareproviders #digitalhealth
