Source Job

• Prepare and submit credentialing and enrollment packets.
• Maintain accurate provider files and track expirations.
• Provide assistance to the billing team during staff absences.

Modena Health and Modena Allergy & Asthma are leading medical practices specializing in allergy, asthma, and immunology care, with clinics across Southern California and Arizona and plans for national expansion. They are physician-led and technology-enabled, committed to transforming allergy care while advancing clinical research and expanding access to cutting-edge medicine.

• Showcase customer service and data entry skills as part of the healthcare team.
• Involved in claims adjudication and/or provider credentialing.
• Support customers by phone, email and chat.

Sutherland helps customers globally achieve greater agility and transform automated customer experiences. As a digital transformation company they have been in business for over 35 years and are Great Place to Work certified with nearly 40,000 employees.

• Assisting with provider credentialing by collecting documentation, entering provider data, submitting required materials to the health plan, tracking completion, and updating internal records.
• Maintaining and updating provider records from various sources in internal systems to ensure accuracy and completeness.
• Supporting reporting requirements, including completing health plan reports on assigned schedules.

Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. They aim to make healthcare affordable, improve patient health, and restore fulfillment in practicing medicine for providers. Powered by AI and Healthguides™, Guidehealth builds connections with patients and providers.

• Lead and innovate within the Credentialing Department, driving operational excellence and compliance.
• Provide strategic direction and oversight to Credentialing Specialists across all lines of business.
• Develop and implement policies, procedures, and best practices for efficient and compliant operations.

Avesis has been providing essential ancillary benefit solutions since 1978, developing and administering best-in-class product choices and services. Today, their programs cover more than 8.5 million members throughout the country, striving for excellence with a focus on member satisfaction and client retention.

• Schedules diagnostic tests, procedures, and surgeries, and may provide patient with necessary preparation instructions.
• Prepares, processes, and manages patient documentation to department database; Acts as a liaison between the patient and billing department.
• Performs daily monitoring and working of the schedule queues and coordinates schedules for staffing.

University of Utah Health enhances the health and well-being of people through patient care, research, and education, striving for a culture of collaboration, excellence, leadership, and respect. As a Level 1 Trauma Center, they are nationally ranked and recognized with five hospitals and eleven clinics.

• Manage provider enrollment & credentialing, leading the credentialing lifecycle for new and existing providers and practice locations.
• Maintain provider data, ensuring CAQH profiles are complete, current, and accurately reflect provider credentials and practice information.
• Optimize workflows, assessing current credentialing processes, identifying inefficiencies, and implementing improvements.

Sailor Health aims to solve the mental health crisis among older adults by connecting them, therapists, healthcare professionals, and insurance plans through their AI-native operating system. They are a growing company partnered with Medicare, offering affordable psychotherapy and striving to redefine aging with mental wellness.

• Own the end-to-end cycle of credentialing applications for new and existing providers under our contracts, ensuring all requirements are met for successful enrollment.
• Assist in building NCQA compliant ongoing monitoring and delegation programs for the Nourish network of RDs.
• Support efforts to streamline existing credentialing processes by providing suggestions for automation or new tools, optimizing individual steps, and ensuring smooth workflows.

Nourish is on a mission to improve people’s health by making it easy to eat well. They are building an AI-native, patient-friendly healthcare system centered on nutrition that improves outcomes, lowers costs, and helps people live healthier, longer lives. Nourish launched three years ago, are live in all 50 states, and already have thousands of dietitians and hundreds of thousands of patients on the platform.

• Support clinical staff by gathering data to complete the medical necessity review process.
• Create and send letters to providers and/or members to communicate information.
• Collaborate with care management teams and stakeholders to provide optimal service.

Wellmark is a mutual insurance company owned by policy holders across Iowa and South Dakota, and they’ve built their reputation on over 80 years’ worth of trust. They are motivated by the well-being of their members, putting them first and committing to sustainability and innovation.