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.
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.
Responsible for economic credentialing and provider enrollment with contracted managed care and governmental plans.
Communicating provider participation information to internal and external customers.
Ensures compliance with regulatory agencies and maintains a working knowledge of statues and laws.
The West Virginia University Health System is West Virginia’s largest health system and the state’s largest employer. They have more than 3,400 licensed beds, 4,600 providers, 35,000 employees, and $7 billion in total operating revenues.
Lead payer credentialing and re-credentialing processes for healthcare providers.
Ensure compliance with accreditation standards, regulatory requirements, and organizational policies.
Oversee payer enrollments, manage the payer credentialing team, maintain data accuracy, and streamline provider onboarding.
Theoria Medical provides comprehensive medical group and technology solutions to serve patients across the care continuum, with an emphasis on post-acute and primary care. They aim to improve the quality of care delivered, refine facility processes, and enhance critical relationships, serving facilities across the United States.
Execute payer enrollment applications from credentialing approval through payer confirmation.
Coordinate CAQH profile maintenance and attestations in alignment with Medallion workflows and payer requirements.
Track enrollment status, follow up with payers, and escalate delays or issues to the Payer Enrollment Manager.
Spring Health aims to eliminate barriers to mental health by delivering the right care at the right time through their clinically validated technology, Precision Mental Healthcare. They partner with over 450 companies and are valued at $3.3 billion.
Manage all aspects of provider licensing, credentialing, and payer enrollment.
Coordinate end-to-end licensing workflows and maintain accurate records.
Act as a key liaison between clinicians, state boards, payers, and internal stakeholders.
They are committed to providing safe, discreet medication abortion treatment and offer a range of reproductive and sexual health care services. The in-house clinical care team composed of board-certified doctors, advanced practice clinicians, nurses, and patient care advocates, is just a text message away.
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.
Manage the full enrollment process for Medicare and Medicaid across applicable states.
Prepare, complete, and submit all required enrollment applications and documentation.
Track application status and follow up with agencies to drive timely approvals.
BetterHelp aims to improve mental health and make mental healthcare accessible. They are the world’s largest online therapy service with over 30,000 licensed therapists, and they value employee mental health, investing in their team’s well-being and professional development.