Maintain individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applications.
Maintain accurate provider profiles on CAQH, NPPES and any other applicable profiles
Complete credentialing applications to add current and new providers to commercial, Medicaid, and Medicare payers
Expressable is a virtual speech therapy practice with a mission to transform care delivery and expand access to high-quality services. They are passionate advocates of parent-focused intervention, serving thousands of clients since their inception in late 2019.
Manage end-to-end provider contracting and credentialing processes.
Maintain accurate and up-to-date provider records and documentation.
Assist with billing setup for newly credentialed providers.
Understood Care helps older adults by providing them with Medicare-covered patient advocacy services. They pair each person with a dedicated advocate who helps them navigate care, reduce costs, and make confident healthcare decisions.
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.
Own end-to-end provider credentialing and enrollment across Medicaid, Medicare, Medicare Advantage.
Ensure credentialing policies and documentation meet payer and regulatory requirements.
Build and continuously improve credentialing infrastructure, including SOPs and policies/procedures.
Zócalo Health is a tech-enabled, community-oriented primary care organization serving people who have historically been underserved by the healthcare system. They partner with health plans, providers, and community organizations to deliver culturally competent care; they are scaling rapidly across states and populations.
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.
Oversee provider credentialing, provider licensing, payer contracting, and network expansion.
Lead end-to-end provider credentialing, provider licensing and recredentialing for MDs and NPs.
Manage relationships with credentialing and contracting vendors.
Sunrise Group is building the future of sleep health by combining innovative technology with expert care. They are a fast-growing team across the US and Europe, backed by more than $50M (€46M) from leading investors including Amazon’s Alexa Fund, Eurazeo, Kurma, and VIVES.
Investigate and resolve insurance claim denials with speed and accuracy.
Partner with payers to resolve issues and secure timely reimbursement.
Provide top-tier phone support to patients, insurance companies, and internal teams.
IVX Health is a national provider of infusion and injection therapy for individuals managing complex chronic conditions like rheumatoid arthritis, Crohn’s disease, and multiple sclerosis. They foster a culture of respect, empowerment, and shared purpose, living out their values every day.
CommonSpirit Health has 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services, making them accessible to nearly one out of every four U.S. residents. They are committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.
Prepares and submits clean claims to various insurance companies.
Identifies and resolves patient billing complaints.
Performs various collection actions including contacting patients by phone.
SelectQuote provides solutions that help consumers protect their most valuable assets: their families, health and property. SelectRX, a subsidiary of SelectQuote, is prioritizing important population health initiatives focused on actively managed, high-touch patient experience.
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.
Provides billing support for the Sandstone Care billing team.
Responsible for verification of benefits, billing data, claims submission, claim corrections, claim re-submissions, claim follow up and appeals.
Generates revenue by making payment arrangements, collecting accounts, monitoring and pursuing delinquent accounts.
Sandstone Care is committed to providing accessible, affordable, and high-quality mental health and addiction treatment services. They strive to create a diverse and inclusive workplace where all employees feel valued, respected, and empowered.
Secures prior authorizations for outpatient imaging and in-office scheduled services.
Acts as a liaison between the payer and clinic schedulers/medical support staff.
University of Utah Health enhances the health and well-being of people through patient care, research, and education. They seek staff committed to compassion, collaboration, innovation, responsibility, integrity, quality, and trust, with five hospitals and eleven clinics.