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 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.
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.
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.
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.
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.
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.
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.
Verify patient insurance coverage, eligibility, and benefits prior to services.
Obtain required prior authorizations from payers for services, procedures, or medications.
Monitor and track pending authorizations; follow up to prevent delays.
Prompt is revolutionizing healthcare with modern software for rehab therapy businesses. As the fastest-growing company in the therapy EMR space, Prompt is setting a new standard in healthcare technology with a team of exceptionally talented individuals.
Review clinical documentation and treatment trajectory to ensure care meets medical necessity standards.
Synthesize clinical documentation, medical record information, and outcomes data to make recommendations on next steps in care.
Partner cross-functionally to support high-quality, clinically appropriate care across the network.
Rula is dedicated to treating the whole person and aims to create a world where mental health is no longer stigmatized. They are a remote-first company committed to providing quality, evidence-based, and compassionate care, empowering individuals to take charge of their mental health.
Coordinate medical record retrieval, ensuring complete and timely submission of patient documentation for provider review
Prepare and process referrals to specialists and manage prior authorization requests in coordination with insurance payors
Virtually greet and room patients prior to telehealth appointments, confirming patient information and visit readiness
Synapticure is a patient and caregiver-founded company that provides instant access to expert neurologists, cutting-edge treatments and trials, and wraparound care coordination and behavioral health support in all 50 states through a virtual care platform. They are dedicated to transforming the lives of millions of individuals and their families living with neurodegenerative diseases like Alzheimer’s, Parkinson’s, and ALS.
Primarily responsible for making outbound calls to healthcare providers.
Accepting inbound calls from healthcare providers.
Answer questions about participation requirements, registration, assessment completion and scoring results.
WNS, part of Capgemini, is an Agentic AI-powered leader in intelligent operations and transformation, serving more than 700 clients across 10 industries. With over 66,000 employees, we combine scale, expertise and execution to create meaningful, measurable impact.
Responsible for the review and processing of claims within the claims transactional system, according to plan benefits and contractual reimbursement terms.
Follows established policies and procedures to pay, pend for additional information, or deny claims.
Accountable to meet and maintain established department production and quality standards.
Evry Health is on a mission to bring humanity to health insurance by expanding benefits, increasing access and transparency, and featuring a personalized, human approach. Evry Health is the major medical division of Globe Life (NYSE:GL) with more than 3,000 corporate employees and 15,000 agents.
Deliver an outstanding customer experience by supporting inquiries across phone, email, text, and chat.
Manage high-complexity insurance workflows and inbound support requests to collect documentation.
Partner with clinical, scheduling, and operations teams to ensure accurate treatment plan alignment and continuity of care.
Expressable is a virtual speech therapy practice that aims to transform care delivery and expand access to high-quality services. Since 2019, they serve thousands of clients with a focus on parent-focused intervention and an e-learning platform with home-based learning modules.
Verify insurance eligibility and benefits for all new Boulder Care commercial enrollments.
Answer incoming questions from patients about balances due and non-covered charges.
Serve as subject matter expert for internal insurance training and identify billing errors.
Boulder Care is an award-winning digital clinic for addiction medicine, recognized for innovation and high quality of patient care. Named by Fortune as one of the Best Workplaces in Healthcare, Boulder fosters a culture of kindness, respect, and meaningful work.
Respond to questions from primary care clinicians on a HIPAA-compliant platform.
Ensure recommendations are educational, cost-effective, and evidence-based.
Participate in product interviews and voluntary projects.
RubiconMD is a web-based electronic consultation platform connecting primary care clinicians with medical specialists. They aim to improve patient care and reduce unnecessary referrals by providing same-day insights from a network of specialists.
Enrolls providers new to Privia with all commercial health plans specific to the market.
Updates and maintains provider enrollment status in credentialing system, CredentialStream.
Performs follow up with health plans according to designated timeline, until Provider is PAR.
Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices. Privia Health consists of scalable cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.
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.