Execute credentialing and enrollment workflows for new providers.
Maintain accurate provider and practice data in credentialing database.
Complete Medicare revalidations, Medicaid recredentialing, and commercial recredentialing per payer schedules.
Integrated Dermatology is a leading national dermatology practice that acquires and partners with dermatology practices across the United States. The culture at ID is filled with hard-working, dynamic individuals who come together to ensure the success of our partner dermatologists.
Enrolling practitioners in health plans in a timely and effective fashion.
Monitoring progress and ensuring timeliness of enrollment completion.
Maintaining provider enrollment goals for all divisions.
Pediatrix Medical Group provides specialized health care for women, babies, and children. Since 1979, Pediatrix has grown into a national, multispecialty medical group committed to coordinated, compassionate, and clinically excellent services.
Ensure timely resolution and completion of payer enrollment.
Streamline processes and workflows for the onboarding department.
Work with internal and external stakeholders to resolve complex provider enrollment issues.
Privia Health collaborates with medical groups, health plans, and health systems to optimize physician practices and improve patient experiences. The Privia Platform consists of scalable operations and end-to-end, cloud-based technology.
Manage the credentialing and re-credentialing processes for physicians, nurses, and allied health professionals.
Verify licenses, certifications, education, training, and work history to ensure providers are fully qualified.
Maintain accurate and complete credentialing files, ensuring all staff are cleared before providing care.
Curana Health focuses on improving the health, happiness, and dignity of older adults. They are a national leader in value-based care, with over 1,000 clinicians serving 200,000+ seniors across 32 states.
Define and execute the long-term vision for credentialing and enrollment, transitioning from manual processes to a tech-enabled, scalable operation.
Oversee the end-to-end enrollment process for Medicare, Medicaid, and Commercial payers. Be the primary liaison for enterprise contract activations.
Lead the internal Credentialing Committee, presenting provider files and ensuring all primary source verifications (NPDB, OIG, SAM) are flawless.
Foodsmart is the leading telenutrition and foodcare solution, backed by a robust network of Registered Dietitians. Their platform is designed to foster healthier food choices, drive lasting behavior change, and deliver long-term health outcomes. At Foodsmart, their mission is to make nutritious food accessible and affordable for everyone, regardless of economic status.
Coordinate the end-to-end provider enrollment process for physicians, nurse practitioners, and physician assistants joining the medical group.
Prepare and submit enrollment applications to Medicare, Medicaid, and other applicable payers to establish billing privileges.
Maintain accurate provider data within internal systems (e.g., NPPES, PECOS, CAQH, and iCIMS/HRIS) to ensure consistency across platforms.
Curana Health is dedicated to radically improving the health, happiness, and dignity of older adults. They are a national leader in value-based care, serving 200,000+ seniors in 1,500+ communities across 32 states and employing more than 1,000 clinicians plus other professionals.
Manage the end-to-end process of licensing applications.
Coordinate the initial credentialing and re-credentialing processes for licensed providers.
Maintain accurate and up-to-date records of all licensing and credentialing activities.
InStride Health delivers specialty anxiety and OCD care. They combine research-backed clinical care and innovative technology to eliminate the major problems with care today, and become the nation’s most trusted provider of pediatric anxiety and OCD care.
Manage and maintain accurate provider credentialing files and profiles.
Support Clinical Operations including Provider communications.
Coordinate full-cycle credentialing, re-credentialing, and insurance contracting.
SimpliFed is focused on providing maternal health services. The company appears to be a startup with a focus on innovation and improving women’s health.
Lead the development, optimization, and performance of Clover’s dental provider network.
Build Clover’s dental network strategy from the ground up across markets.
Build, scale, and lead a high-impact dental network team spanning contracting, analytics, and provider relationship management.
Clover Health is committed to providing high-quality, affordable, and easy-to-understand healthcare plans for America’s seniors. The company prioritizes preventive care while leveraging data and technology; they are passionate and mission-driven individuals with diverse areas of expertise.
Develop collaborative relationships with insurance companies/payors to verify benefits and eligibility.
Enter and update patient demographics, guarantor, and insurance information in company systems.
Respond to inquiries from insurance companies and internal team members.
Equip is a virtual, evidence-based eating disorder treatment program ensuring everyone can access treatment. Founded in 2019, Equip has been fully virtual since its inception and is proud of their highly engaged team, with recognition from Time, Linkedin, and Lattice.
Deliver exceptional support that drives meaningful value for our dental practices
Provide support on questions related to billing and claims that are sent through Archy and its integration with dental clearinghouse
Conduct 1:1 training with practices and their staff that showcase Archy’s capabilities
Archy is a vertical SaaS solution that is revolutionizing the dental practice management space, giving dental providers cutting-edge software that allows them to do what they do best (be dentists!). They have a remote-friendly culture.
Lead and develop a team of Payer Enrollment Coordinators and Specialists.
Manage and improve the systems that help support the team’s processes.
Medallion provides a provider operations platform to eliminate administrative bottlenecks. They are ranked No. 3 on Inc. Magazine’s 2024 Fastest-Growing Private Companies in the Pacific Region and have $130M in funding.
Inputs and updates insurance information in appropriate screens.
Verifies insurance eligibility online or by phone and identifies primary and secondary insurance.
Obtains claim numbers and verifies claims for Workmen’s Comp and Auto Insurance.
Munson Healthcare is a healthcare provider. They require all employees to be vaccinated or have lab-confirmed immunity for certain diseases and to receive a flu vaccine annually, with medical or religious exemptions available.
Manage multiple channel interactions with excellent communication skills.
Effectively present and discuss products and services to providers.
Establish and maintain positive relationships with providers.
Capital BlueCross is an independent licensee of the Blue Cross Blue Shield Association. We are an equal opportunity employer committed to a culture of diversity and inclusion.
Contacts insurance companies for status on outstanding claims.
Processes and follows up on appeals to insurance companies.
Works outstanding accounts receivable from assigned work queues.
US Anesthesia Partners is dedicated to providing high-quality anesthesia services. They offer equal employment opportunities to all employees and applicants.
Responsible for establishing and maintaining positive relationships with various providers.
Drives provider engagement and communication, supporting network development.
Manages provider performance, shares data, and supports the implementation of quality initiatives.
CommonSpirit Health has over 700 care sites across the U.S., offering services from clinics and hospitals to home-based and virtual care. They are committed to building healthy communities and advocating for those who are poor and vulnerable.