Manage end-to-end provider credentialing and payer enrollment processes across multiple states.
Ensure compliance with government and commercial payer requirements to minimize claim denials.
Serve as a subject matter expert, supporting team training and process improvements.
The company operates a nationwide virtual healthcare network, focusing on transforming cardiovascular care delivery. The team is mission-driven and values innovation, collaboration, and continuous improvement.
Design and launch credentialing workflows, quality standards, and operational processes from the ground up.
Manage the complete credentialing lifecycle including payer enrollment, CAQH management, and compliance monitoring.
Recruit, train, and lead credentialing specialists to scale the service while maintaining accuracy and reliability.
This partner company specializes in healthcare credentialing and revenue cycle management. They offer a dynamic, globally distributed team culture with a focus on efficiency and compliance.
Coordinate and monitor provider/facility payer credentialing and re-credentialing processes.
Send, review, and verify credentialing applications and maintain provider information in online database.
Track license and certification expirations and ensure timely renewals for medical staff.
Bozeman Health is a healthcare organization dedicated to caring for the communities of Southwest Montana. They foster a Culture of Excellence emphasizing high performance, transparent communication, and continuous learning.
Submit and track provider enrollments across Medicare/Medicaid and commercial payers to secure effective dates.
Maintain CAQH attestations and accurate provider data across payer portals and internal credentialing systems.
Assist with onboarding new providers and respond to payer requests to resolve application issues.
Metro Vein Centers is a rapidly growing healthcare practice specializing in state-of-the-art vein treatments. With over 70 clinics across 8 states and a Net Promoter Score of 93, they are committed to compassionate, patient-first care.
Lead the full credentialing and recredentialing process for W-2 clinicians across multiple states and payer networks.
Develop and maintain credentialing policies aligned with NCQA, CMS, and state-specific guidelines.
Partner with recruiting, clinical operations, legal, and finance to ensure efficient onboarding and regulatory compliance.
Headlight is a mental healthcare company founded by psychiatrists, transforming access to care and delivery methods for clinicians. They are a growing organization with a collaborative culture, focusing on innovation and whole-person care.
Manage end-to-end payer enrollment for providers across commercial, Medicare, and Medicaid health plans.
Support provider licensing operations including new applications, renewals, and compliance activities.
Collaborate with internal teams and external partners to ensure timely credentialing and minimize patient care delays.
Oshi Health is a virtual digestive health practice transforming GI care by combining compassionate, multidisciplinary care with innovative technology. The company is a remote-first, mission-driven startup focused on revolutionizing how chronic digestive conditions are diagnosed and managed, with a culture emphasizing respect and inclusion.
Create and maintain credentialing and renewal information for Workit providers, ensuring accuracy in payor directories and online systems.
Work closely with the Credentialing Manager and billing staff to resolve denials or authorization issues related to provider credentialing.
Complete revalidation requests issued by payers and maintain up-to-date data for each provider in the credentialing database.
Workit Health is an industry-leading provider of on-demand, evidence-based telemedicine care for addiction, offering FDA-approved medication and online recovery groups. The company has a vibrant, democratized culture with multiple ERG groups and opportunities for internal mobility, committed to closing health disparity gaps.
Build, document, and maintain end-to-end SOPs for payer contracting, enrollment, and credentialing workflows.
Design quality controls and error-catching checkpoints that reduce rework and rejected applications.
Conduct persistent, proactive follow-up with payers to push applications through to approval.
Allara is a comprehensive women's health provider that specializes in expert, longitudinal care for women through every life stage. Trusted by over 60,000 women nationwide, Allara is one of the fastest-growing women's health platforms in the U.S., bridging gaps in healthcare for women.
Manage provider credentialing and enrollment processes to ensure compliance with NCQA, URAC, Joint Commission, CMS, and state regulations.
Oversee a team of specialists, monitor KPIs like "Days to Enroll," and resolve complex application rejections to protect cash flow.
Collaborate with Compliance, Billing, Legal, and Clinical teams to troubleshoot credentialing-related claim denials and maintain database accuracy.
Sleep Doctor is a trusted sleep health company helping millions get better rest through clinical expertise and consumer-first experiences. They foster a collaborative, growth-oriented culture where every team member contributes to bold solutions.
Oversee the processing of initial payer applications to ensure compliance with accreditation standards and regulations.
Maintain and manage payer credentialing databases with accuracy and audit readiness.
Supervise payer credentialing staff by coordinating workloads, providing training, and monitoring performance.
Theoria Medical is a comprehensive medical group and technology company dedicated to serving patients across the care continuum with an emphasis on post-acute care and primary care. They serve facilities across the United States, offering multispecialty physician services, telemedicine, and remote patient monitoring.
Review BCBA and behavioral health provider credentialing packets for completeness, accuracy, and primary source verification.
Conduct routine and ad hoc audits of delegated credentialing files to ensure compliance with payer, accreditation, and regulatory requirements.
Support pre-delegation and annual delegation audits, maintain tracking systems, and collaborate with teams to improve processes.
The partner company focuses on improving access to high-quality behavioral healthcare services through credentialing and provider network management. They operate in a mission-driven remote environment with a collaborative team culture committed to innovation and quality.
Coordinate clinician onboarding by maintaining accurate ATS records and distributing required credentialing documentation.
Verify licenses, certifications, education, and background checks to ensure compliance with state, federal, and Joint Commission standards.
Track expiring credentials, communicate renewal requirements, and proactively manage compliance deadlines to maintain clinician eligibility.
International SOS Government Medical Services supports healthcare programs that improve patient care and operational readiness across the U.S. and internationally. Founded in 1984, the company operates in more than 90 countries, delivering healthcare, medical assistance, emergency response, and workforce support services worldwide.
Perform daily audits on client data for completeness and accuracy of coding using clinical knowledge.
Respond to provider appeals and meet client turnaround time and KPI goals.
Utilize coding validation training to become familiar with claims payment policies and regulations.
Cotiviti is a healthcare analytics company that uses data-driven solutions to improve payment accuracy and quality in healthcare. The company offers a competitive benefits package and fosters a collaborative, fast-paced work environment.
Oversee end-to-end health plan enrollment process and manage vendor performance.
Ensure accurate and timely processing of enrollment requests while maintaining compliance with SLAs.
Act as subject matter expert in payer enrollment requirements and resolve enrollment delays.
Medallion is a healthcare technology company that automates licensing, credentialing, and compliance monitoring for healthcare organizations. It is one of the fastest-growing healthcare technology companies, ranked #3 on Inc. Magazine's 2024 Fastest-Growing Private Companies in the Pacific Region and a Glassdoor Best Place to Work in 2024 & 2025.
Own the licensing vendor relationship and budget, directing vendor performance and holding them accountable.
Manage payer credentialing end to end, ensuring providers are enrolled and revenue-ready.
Own payer roster management and develop relationships with payer representatives to resolve issues.
Brightline provides pediatric behavioral health care via virtual and in-person services, including therapy and psychiatry for kids up to age 18. Founded in 2019, the company has served tens of thousands of families and is nationally recognized for clinical excellence.
Manage and resolve claims rejections and denials, escalating trends as identified.
Verify patient eligibility and benefits, and coordinate with insurance payers.
Maintain compliance with HIPAA regulations and meet productivity standards.
Workit Health is an industry-leading provider of on-demand, evidence-based telemedicine care for addiction. They are a growing company with a dedicated team passionate about making judgment-free care accessible.
Manage the full medical billing and Revenue Cycle Management (RCM) process, including AR follow-up and claim denial resolution.
Complete provider credentialing and recredentialing, verify insurance eligibility, and maintain accurate records within Athena.
Ensure HIPAA compliance and communicate with insurance companies regarding claims, credentialing, and payment issues.
SnappyCX connects skilled professionals with growing healthcare practices. They seek self-motivated individuals to support financial and administrative operations in a remote, fast-paced environment.
Identify, research, process, and resolve customer inquiries regarding health insurance benefits, claims, and eligibility.
Analyze medical records and apply medical necessity criteria to determine the appropriateness of benefit requests.
Maintain accurate records, meet quality and timeliness standards, and coordinate with internal departments and external organizations.
Blue Cross Blue Shield of Arizona provides health insurance products and services to individuals, families, and businesses, aiming to inspire health and make it easy. The company has been recognized as a Healthiest Employer and has transformed healthcare for over 80 years with teams in Phoenix, Tucson, Chandler, and Flagstaff.
Review and analyze provider applications and documentation to determine eligibility for the global provider network.
Verify credentials, licenses, and qualifications against country-specific requirements and company standards.
Maintain accurate provider records and collaborate with internal stakeholders on compliance.
ComPsych is the world's largest provider of mental health services and GuidanceResources® for life, serving over 163 million individuals across 200 countries. Over 40% of the Fortune 500 choose ComPsych for their mental health needs.
Provide member-centered support by answering inbound calls and chats with empathy and clarity.
Resolve core member issues including benefits coverage, cost-sharing concepts, and network provider searches.
Own issues end-to-end using established workflows and document interactions accurately.
Included Health is a healthcare company delivering integrated virtual care and navigation. They are remote-first and focus on raising the standard of healthcare for everyone.