Complete credentialing and re-credentialing applications for physicians, ancillary providers, and facilities with third-party payers and governmental programs.
Prepare and manage provider credentialing and payer enrollment applications for commercial, Medicare, Medicaid, and other health plans.
Maintain accurate provider files including CAQH profiles, NPI information, state licenses, and other required documentation.
Monitor credentialing statuses through payer portals and communicate updates to leadership and providers.
Modena Health is a physician-led, hospitality-focused medical practice specializing in allergy, asthma, and immunology care, with clinics across Southern California and Arizona and plans for national expansion. The company values collaboration, positivity, and growth, aiming to hire great people and help them find meaning in its mission.
Manage end-to-end credentialing and payer enrollment for behavioral health providers and facilities.
Serve as subject matter expert on credentialing requirements, ensuring timely and compliant files.
Coordinate with HR, Talent Acquisition, and leadership to facilitate provider onboarding and resolve issues.
We are a leading provider of immediate-access behavioral health crisis care. We are physician-led and data-driven, with over 15 years of crisis care expertise, recognized as a national best practice.
Responsible for credentialing and recredentialing practitioner applicants to ensure regulatory compliance.
Conducts primary source verifications, reviews applications, and communicates with healthcare practitioners to obtain missing information.
Maintains credentialing database, monitors provider expirables, and assists with audit reviews.
Curana Health provides value-based care solutions, including on-site primary care, Accountable Care Organizations, and Medicare Advantage plans, to senior living communities and skilled nursing facilities. Founded in 2021, the company has grown to serve over 200,000 seniors across 1,500+ communities in 32 states, employing more than 1,000 clinicians and staff, and was ranked #147 on the Inc. 5000 list of fastest-growing private companies.
Manage end-to-end facility credentialing and privileging for providers across SNFs nationwide.
Prepare and track credentialing applications, facility packets, and compliance files.
Coordinate with facilities to resolve credentialing, access, and EMR issues in a timely manner.
Limitlessli specializes in recruiting, hiring, and managing high-caliber remote staff for healthcare facilities, leveraging a global network to connect clients with qualified professionals. The company offers a flexible remote work environment where employees collaborate with an international team and contribute to a growing business.
Review facility credentialing applications for accuracy and completeness based on applicable standards.
Communicate with facilities to resolve discrepancies and obtain missing information.
Manage data entry, monitor compliance, and prepare reports for the Credentialing Committee.
Curana Health is a national leader in value-based care for senior living communities and skilled nursing facilities. Founded in 2021, the company serves 200,000+ seniors across 1,500+ communities in 32 states with a team of over 1,000 clinicians and professionals, and was ranked #147 on the Inc. 5000 list.
Own delegated credentialing operations across assigned payer relationships.
Manage payer audits, compliance reporting, and audit-ready credentialing files.
Support NP and group practice credentialing while partnering with internal teams.
Tava Health is reimagining mental health care to make it as accessible and stigma-free as a checkup, connecting patients with therapists and improving provider care. It is a fast-growing, mission-driven team leveraging technology to deliver high-quality mental health care to everyone.
End-to-end credentialing and payer enrollment for multi-state providers across commercial and Medicaid plans.
Vendor governance and SLA performance management to ensure timely provider onboarding.
Delegated credentialing and audit readiness, including NCQA and MCO compliance.
Blackbird Health provides virtual and in-person mental health services for children across Pennsylvania, Virginia, New Jersey, and Maryland, focusing on a whole-child approach that integrates brain, body, and behavior. The company is clinician-founded and owned, with a collaborative, supportive, and innovative team that is expanding into new markets in 2027.
Receive medical claims from healthcare providers or patients and verify supporting documentation to ensure completeness.
Interpret Explanation of Benefits (EOB) and CMS-1500 forms, then evaluate claims against program-specific business rules for approval or rejection.
Provide support to customer inquiries via phone, email, or fax while maintaining HIPAA compliance and meeting daily productivity goals.
IQVIA is a leading global provider of clinical research services, commercial insights, and healthcare intelligence to the life sciences and healthcare industries. With operations in over 100 countries, they cultivate a diverse, collaborative culture focused on improving patient outcomes.
Own the multi-state licensing roadmap and execute applications and renewals for clinicians across MD, DO, NP, and RN pathways.
Manage payer credentialing strategy, including CAQH profiles, commercial payer applications, and Medicare enrollment via PECOS.
Support clinical operations compliance, including scope of practice, collaborative agreements, and prescriptive authority tracking.
Daymark Health is a value-based oncology company redefining the cancer care experience for patients, providers, and health plans. The company is backed by leading venture firms and led by a team of pioneers in oncology and value-based care.
Manage standard onboarding workflows for physical therapist enrollment across contracted payers and partner networks.
Review provider credentials, prepare application packets, and maintain accurate database records for compliant credentialing.
Communicate with insurance carriers and internal teams to ensure timely enrollment and resolve routine barriers.
Luna is revolutionizing the delivery of physical therapy by providing in-home care through a digital platform. As a start-up with supportive leadership, they offer opportunities for growth alongside a dedicated team.
Serve as the primary financial contact for caregivers during onboarding, explaining insurance benefits and estimated costs.
Collaborate with care coordination and clinical teams to ensure a seamless onboarding experience.
Maintain accurate documentation of all caregiver interactions while upholding HIPAA and privacy standards.
Lyra Health is a leading provider of evidence-based mental health care, serving over 20 million people globally. The company has a collaborative culture focused on delivering transformative care through technology.
Collect, verify, and submit information necessary for enrollment of hospitals/physicians with Out-of-State Medicaid payers.
Develop and maintain ongoing policies and procedures specific to each state for new hospital/physician enrollments.
Manage work queue to ensure all timely submissions and deadlines of payor-specific forms and documents.
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified E360 RCM platform. The company is a multi-year recipient of the Top Workplaces award, recognized as Black Book's #1 Specialty Revenue Cycle Management provider in 2024, and has been among the top one percent of Inc. 5000 fastest-growing private companies for eleven years.
Conduct audits of medical records for compliance with federal coding regulations and guidelines.
Provide education and training to providers on CPT, ICD-10, and HCPCS codes.
Act as an internal expert to ensure coding compliance with state and federal regulations.
Privia Health is a technology-driven national physician enablement company collaborating with medical groups, health plans, and health systems. It aims to optimize physician practices and improve patient experiences through cloud-based technology and scalable operations.
Protera Health is a health-tech startup transforming the delivery of musculoskeletal (MSK) care through a multidisciplinary approach and patient tracking technology. Founded by orthopedic surgeons and value-based care experts, it is a growing team that emphasizes collaboration, innovation, and a patient-first culture.
Coordinate the end-to-end provider enrollment process, preparing and submitting applications to Medicare, Medicaid, and other payers.
Maintain accuracy of provider data in systems like NPPES, PECOS, and CAQH, and track facility privileging requirements.
Collaborate with internal teams to align enrollment timelines and ensure compliance with federal, state, and facility regulations.
Curana Health is a national leader in value-based care for older adults, providing primary care services and care coordination in senior living communities and skilled nursing facilities. Founded in 2021, the company serves over 200,000 seniors across 1,500+ communities and employs more than 1,000 clinicians, with a fast-paced, mission-driven culture.
Review and analyze Medicare claims sampled by the Department of Justice to determine correct coding and payment based on coverage and utilization.
Conduct in-depth claims analysis to detect fraudulent or abusive billing practices using ICD-10, CPT-4, and CMS guidelines.
Complete summary reports and communicate findings internally while maintaining confidentiality and compliance with DOJ and CMS regulations.
Empower AI provides AI-powered solutions for federal government agencies, helping them transform their workforce and operations. Headquartered in Reston, Va., the company has three decades of experience in Health, Defense, and Civilian missions and is recognized as a 2024 Military Friendly Employer.
Apply certified coding expertise to healthcare coding activities while maintaining high accuracy and quality.
Review and interpret clinical and administrative documentation to support appropriate coding outcomes.
Follow established coding standards, policies, and regulatory requirements while protecting data confidentiality.
A partner company in the healthcare coding industry seeks a certified coding professional. The full-time remote role supports accurate and compliant coding operations in a structured environment.
Respond to high-volume inquiries via email and phone, assisting with triaging case volumes and providing resolution guidance on complex claims and billing inquiries.
Critically analyze situations, escalate issues to appropriate teams, and identify recurring issues to provide feedback to management.
Act as a subject matter expert, updating team on resources, supporting team chat, and remaining flexible to take on other duties as assigned.
Privia Health is a technology-driven physician enablement company that collaborates with medical groups, health plans, and health systems to optimize practices and improve patient experiences. They are led by top industry talent and physician leadership, focusing on scalable operations and cloud-based technology to reduce healthcare costs and improve outcomes.
Lead a production-focused pod of Operations Analysts and Credentialing Specialists, owning day-to-day credentialing operations.
Drive team performance by monitoring speed, quality, and efficiency metrics, ensuring SLAs are consistently met.
Coach, mentor, and train team members, conducting daily standups and weekly performance reviews.
CertifyOS builds the data infrastructure for modern healthcare, automating provider licensing, credentialing, and network monitoring. It is backed by leading investors and values authenticity, accountability, collaboration, results, and openness to feedback.
Independently audit professional-fee coding for accuracy, compliance, and reimbursement impact.
Evaluate ICD-10-CM, CPT, HCPCS Level II, E/M services, modifiers, and professional components.
Prepare reports, deliver coding education, and maintain 95% audit accuracy.
A large regional healthcare network providing medical services across multiple facilities. The culture emphasizes independent auditing, high accuracy, and collaborative compliance education.