Complete enrollment and re-credentialing applications for physicians and providers with payers and government programs.
Perform primary source verification of licenses, malpractice, and work history and maintain CAQH profiles.
Partner with clients and payers to update enrollment status and communicate project status to leadership.
BerryDunn is a professional services firm that provides tax, advisory, and consulting services to businesses, nonprofits, and government agencies throughout the US and its territories. The firm is known for its diverse and inclusive workplace culture with a focus on learning, development, and well-being.
Manage end-to-end provider licensing workflows across multiple states, including initial applications and renewals.
Own payer enrollment processes for commercial and government payers from initial application through active status.
Build and maintain accurate tracking systems to monitor license and credential expiration dates, ensuring zero lapses.
Hey Jane provides safe, discreet medication abortion treatment and a range of reproductive and sexual health care services via your phone. We have helped over 100,000 people and have an in-house clinical care team of board certified doctors, nurses, and patient care advocates.
Facilitate client calls related to contracting and payer enrollments.
Run and analyze client KPIs, providing regular reports.
Manage the full contracting and payer enrollment process.
Experity transforms on-demand healthcare across the U.S. by empowering urgent care clinics with industry-leading software. The company fosters a team-first culture with opportunities for flexible work and career development.
Manage the provider data ticketing queue, ensuring timely resolution of requests.
Partner with team members to obtain required data elements and validate completeness.
Identify and implement opportunities to streamline provider data structure and workflows.
Curana Health is committed to radically improving the health, happiness, and dignity of older adults. They serve 200,000+ seniors in 1,500+ communities across 32 states, with over 1,000 clinicians, care coordinators, analysts and professionals.
Coordinate end-to-end provider credentialing and re-credentialing processes with commercial and government payers.
Support payer contracting activities, including data collection, application submission, and follow-up.
Maintain accurate provider credentialing files in accordance with regulatory and accreditation standards.
Sunrise Group builds the future of sleep health by combining breakthrough technology with expert care. Backed by more than $50M, their team of 100+ clinicians, engineers, and operators across the US and Europe is dedicated to making high-quality sleep care accessible to everyone.
Provide day-to-day guidance, training, and support to credentialing associates.
Design, document, and implement scalable credentialing workflows and standard operating procedures.
Maintain accurate provider information, track application statuses, and analyze data to improve efficiency.
BetterHelp aims to remove traditional barriers to therapy and make mental health care more accessible. Founded in 2013, it is the world’s largest online therapy service, with a network of over 30,000 licensed therapists and a team of clinicians, engineers, marketers, and business leaders committed to expanding access.
Review assigned TEFCA directory entries against authoritative corroboration sources and apply the approved review methodology.
Research, validate, and reconcile healthcare directory data across multiple reference sources, documenting findings in Jira.
Classify entries using a four-tier disposition taxonomy and escalate exception-path entries to the Lead Analyst.
Broadway Ventures is an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB) that provides expert program management, technology, and consulting solutions to government and private sector clients. As a small business, they emphasize integrity, collaboration, and excellence in their tailored solutions.
Own the end-to-end lifecycle of enrollment data, from inbound 834 file processing through system validation and data entry to ongoing maintenance.
Perform systematic data validation and quality assurance, identifying anomalies, duplicates, and discrepancies while executing scheduled and ad-hoc audits.
Lead targeted data cleanup projects and collaborate cross-functionally with engineering, claims, and population health teams to resolve data issues.
Evry Health is on a mission to bring humanity to health insurance, offering high-technology health plans that expand benefits and increase access. As the major medical division of Globe Life, it has 16.8 million policies in force and over 3,000 corporate employees and 15,000 agents, with a 45-year A (Excellent) rating from A.M. Best Company.
Serve as the primary point of contact for physicians, clinics, and healthcare stakeholders, ensuring consistent communication and trusted relationships.
Support healthcare providers in navigating patient assistance programs, including enrollment, reimbursement, and therapy access processes.
Manage and complete all required documentation such as special authorizations, prescription renewals, and enrollment forms with accuracy and timeliness.
Jobgether is an AI-powered job matching platform that connects candidates with hiring companies. They use technology to ensure fair and efficient recruitment processes, and foster inclusive employee programs.
Serve as the primary contact for CM/UM programs and operational questions related to the MyCare Platform.
Build relationships with provider offices through outreach and timely follow-up, resolving issues within defined turnaround times.
Educate providers on submission requirements, documentation, timelines, and available CM/UM resources.
Personify Health created a personalized health platform, bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together. They serve employers, health plans, and health systems with data-driven solutions that reduce costs while improving health outcomes.
Maintains practice management systems, processes insurance claims, and reconciles patient accounts.
Investigates rejected claims, corrects denials, and facilitates payment through collections and billing reminders.
Ensures HIPAA compliance, resolves patient billing issues, and provides professional customer service.
US Anesthesia Partners provides anesthesia services and revenue cycle management. It is a large US-based healthcare organization focused on billing and insurance operations, emphasizing accuracy and compliance.