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.
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.
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.
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.
Execute non-delegated credentialing process for new and existing providers.
Serve as a point of contact for all insurance payor relationships.
Maintain accurate and up-to-date records of all credentialing activities.
Dental Care Alliance's mission is to advance the practice of dentistry by partnering with and supporting dental professionals to create a lifetime of healthy smiles. Headquartered in Sarasota, Florida, DCA supports over 400 allied practices and supports over 900 dentists across over 20 States.
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.
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.
Manage complex provider roster creation, submission, and record reconciliation.
Oversee resolution of moderate-scope issues by prioritizing tasks.
Serve as main contact for roster inquiries, collaborating with internal teams and external payers.
Aledade empowers independent primary care practices to deliver better care and thrive in value-based care. Founded in 2014, they are the largest network of independent primary care in the country with a collaborative, inclusive, and remote-first culture.
Own the eligibility and enrollment product area: ingestion, validation, enrollment lifecycle, payer data integrations, and cross-platform eligibility signals
Build and improve the tools, campaigns, and workflows that drive member activation and engagement — not just data plumbing, but the experiences that turn eligibility into impact
Partner with engineering, operations, payer partnerships, and marketing to deliver compliant, resilient, and extensible solutions
Maven is the world's largest virtual clinic for women and families on a mission to make healthcare work for all. More than 2,000 employers and health plans trust Maven's end-to-end platform to improve clinical outcomes and reduce healthcare costs. Maven has an award-winning culture.
Manage provider relationships and drive engagement within your assigned territory.
Execute strategic initiatives, including supporting providers and coordinating events.
Act as the primary point of contact for providers and community organizations.
Imagine Pediatrics is a tech-enabled, pediatrician-led medical group that reimagines care for children with special health care needs. They deliver 24/7 virtual-first and in-home medical, behavioral, and social care, working alongside families, providers, and health plans.
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.
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.
Collecting and verifying current demographic information
Contacting insurance companies when needed
Pediatrix Medical Group is a physician-led organization and one of the nation’s largest providers of prenatal, neonatal, and pediatric services. They focus on a team approach to improve the lives of patients everywhere, offering diverse opportunities and a commitment to clinical excellence.
Acts as initial service ambassador to referral sources, physicians, patients, caregivers and other external customers providing the highest quality service.
Responsible for the initial entry, verification, and maintenance of information regarding new patients in all applicable software programs.
Processes private insurance verifications, verifies eligibility of Medicare, Medicaid and third party payers and any other duties as directed.
CommonSpirit Health at Home is a full-service health care organization that believes the best place for someone to get better is in their own home. As a faith-based organization, they are committed to finding new ways to improve the health of their patients and the health of the communities they serve.
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.
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.
Maintain full ownership and accountability for initiating phone contact to potential study participants.
Conduct phone-based pre-screening interviews for potential study participants to determine pre-qualification status.
Consistently provide outstanding customer service with every patient interaction.
M3 Wake Research is an integrated network of premier investigational sites meeting clinical research needs. They have close to 30 owned and managed research sites across the country and continue to grow through acquisitions.
Review and process patients’ enrollment forms to the Patient Assistance Program (PAP).
Caretria is dedicated to improving patient access to medications. Become one of their contributors and join the Caretria Team! They offer a comprehensive benefits package.
Perform outbound calls to obtain appropriate information and document accurately.
Answer in-bound calls and assist customers with pharmacy related services.
Contact insurance companies for benefit investigation and coverage eligibility.
IQVIA is a global provider of clinical research services, commercial insights, and healthcare intelligence to the life sciences and healthcare industries. They create connections that accelerate the development and commercialization of innovative medical treatments to improve healthcare and patient outcomes.
Conduct outreach calls to practices, and build immediate rapport and trust by adapting approach to their needs
Lead individual and group practice meetings to build successful workflows with the Stellar application and drive performance on key outcomes
Quickly triage inbound emails and answer questions from practices
Stellar Health helps primary care providers put patient health first with their technology platform, people, and analytics. They are a US-based Health-tech backed by Top VCs with an established product & proven operating model.