Manage day-to-day credentialing and re-credentialing workflows for Tia’s provider network.
Support medical licensing workflows for MDs, DOs, NPs, PAs, and RNs across multiple states, including tracking requirements, deadlines and renewals.
Track onboarding progress and help ensure providers are licensed, credentialed, enrolled, and compliant before go-live.
Tia is building a new model for women’s healthcare, one that treats women as whole people. They are a Series D, venture-backed company trusted by more than 120,000 women across four markets, building a culture of excellence in people, process, and product.
Processes applications for credentialing and privileging, both initial and reappointment, adhering to policies and procedures related to legal, state, OHSU, DNV, TJC, and NCQA guidelines.
Investigates and validates discrepancies and adverse information from applications and primary source verifications, communicating with credentialing contacts ensuring timely and accurate completion.
Maintains practitioner credential files, containing confidential peer review information, and updates credentialing databases with detailed documentation during all steps, from receipt of application to processing completion.
OHSU is Oregon's only public academic health center, focused on patient care, research, and training the next generation of healthcare professionals. As Portland's largest employer, OHSU provides opportunities for learning and advancement within its system of hospitals and clinics.
Research, interpret, and evaluate information relevant to provider licensure and continuing medical education in the United States.
Complete applications for provider credential, licensure or payor enrollment on behalf of Certify customers.
Validate and authenticate information updated on the credentialing, licensing platform and ensure 100% accuracy.
CertifyOS is building the data infrastructure that powers modern healthcare. Their API-first platform automates provider licensing, enrollment, credentialing, and network monitoring by connecting directly to hundreds of primary data sources. The company values authenticity, accountability, collaboration, results, and openness to feedback.
Manage initial credentialing and re-credentialing applications for physicians and mid-level providers across multiple U.S. states.
Complete and maintain CAQH ProView profiles, ensuring all provider data is accurate, current, and attestation-ready.
Submit and track payer enrollment applications with commercial insurance companies, Medicare, and Medicaid programs.
AMS Solutions is a leading medical billing and revenue cycle management company serving healthcare practices across the United States. They specialize in helping physicians maximize their revenue through expert billing, coding, credentialing, and practice management services.
Managing the credentialing, payer enrollment, and provider onboarding processes for physicians and advanced practice providers.
Ensuring providers are credentialed, enrolled, and maintained with commercial and government payers in a timely and accurate manner.
Maintaining provider records, monitoring credentialing deadlines, and coordinating with payers and providers.
Modena Health (MH) and Modena Allergy & Asthma (MAA) are leading and rapidly growing medical practices specializing in allergy, asthma, and immunology care, with clinics across Southern California and Arizona, and ambitious plans for national expansion. They are physician-led, hospitality-focused, and technology-enabled, committed to transforming allergy care while advancing clinical research and expanding access to cutting-edge medicine.
Ensure timely and accurate processing of credentialing and recredentialing for both individual practitioners and organizations.
Coordinate Credentialing Committee meeting, including preparing the agenda and documenting meeting minutes.
Identify missing or erroneous information from the provider’s application, and communicate with the provider to obtain.
Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. They offer a variety of health insurance products and services as well as providing information and tools to help individuals make better health decisions. At AZ Blue, they have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work.
Manage end-to-end delegated credentialing operations across an assigned portfolio of payors.
Prepare, coordinate, and execute both pre-delegation and annual credentialing audits.
Build and deliver reporting packages for submission to delegated entities & payors.
Grow Therapy is a company that serves as a trusted partner for therapists growing their practice, and patients accessing high-quality care. They are powered by technology as a three-sided marketplace that empowers providers, augments insurance payors, and serves patients with over ten thousand therapists and hundreds of thousands of clients across the country.
Performs utilization review to determine medical necessity criteria compliance and facilitates resolution of escalated cases.
Collaborates with clients and physician reviewers, ensuring adherence to all HIPAA, state, federal, and regulatory standards like URAC & NCQA.
Utilizes various computer systems to manage cases, engages in provider communication, and participates in quality management programs while prioritizing independent work.
WNS, part of Capgemini, is an AI-powered leader in intelligent operations and transformation, serving over 700 clients across industries like Healthcare and Financial Services. It is a large global company with over 66,000 employees, combining deep domain expertise with AI platforms to create lasting business value.
Lead and manage a team of Credentialing Specialists and Operational Analysts to ensure timely and accurate credentialing file processing.
Oversee credentialing workflows to ensure compliance with NCQA guidelines, state regulatory requirements, and client-specific policies.
Partner with internal stakeholders to resolve escalations, streamline workflows, and improve operational outcomes.
CertifyOS is building the data infrastructure that powers modern healthcare. They value authenticity, accountability, collaboration, results, and openness to feedback, fostering a high-ownership team focused on solving real infrastructure problems.
Manage end-to-end provider licensing, including application preparation, submission, and follow-up across multiple states.
Coordinate and track licensing timelines, proactively following up to avoid delays.
Assist with the development and maintenance of workflows and processes for licensing operations.
Midi Health is a virtual care clinic focused on helping women navigate perimenopause, menopause, and other midlife health challenges. At Midi, they’re building the future of women’s healthcare and growing quickly.
Perform accurate code assignments for ED records (facility and profee) while working remotely.
Be flexible, detail-oriented and have the ability to work independently.
Meet client productivity targets while maintaining coding quality of 95% or greater.
UASI is a company that values its employees! They have been awarded the Top Workplace award by the Cincinnati Enquirer in 2022 and 2023. Their 40 years in business contributes to the long tenure of their team.
Act as the first contact for new patients, discussing services with a supportive approach and coordinating patient/provider matching.
Conduct insurance eligibility verification and update patient charts with benefit information like copay and deductible.
Manage patient intake via phone, email, and text, schedule evaluations, and handle tasks like waitlist management and processing referrals.
Rivia Mind is a psychiatrist-owned mental health practice providing compassionate, science-based care through virtual and hybrid appointments across multiple US states. The company cultivates a collegial, growth-oriented culture rooted in shared values, curiosity, and authentic connection.
Evaluates medical records to provide clinical and surgical abstraction for complex professional services, ensuring coding accuracy and compliance with national guidelines.
Consults with medical providers to clarify record information and accurately code diagnostic and procedural data using ICD-10-CM and CPT-4.
Works independently in a remote setting, utilizing coding software to maintain productivity and quality standards while supporting department projects and validation edits.
Banner Health is one of the largest nonprofit health care systems in the country, providing hospital services, primary care, research, and more across its network. It is a Great Place To Work® Certified organization with a large, skilled workforce committed to patient care and employee wellbeing.
Works with field staff and Manager, Clinical Services (MCS) to appropriately schedule clinicians for cases in assigned areas of responsibility.
Communicates appropriately regarding changes in schedule or service delivery.
Demonstrates the ability to be efficient and productive by organizing job duties and responsibilities.
CommonSpirit Health at Home is a full-service health care organization that believes the best place for someone to get better is in their own home. As a faith-based organization, we are committed to finding new ways to improve the health of our patients and the health of the communities we serve.