Lead one of Rula’s most critical operational functions.
Own end-to-end credentialing and enrollment outcomes.
Partner across the company to ensure providers are credentialed and enrolled accurately, compliantly, and efficiently.
Rula is dedicated to treating the whole person, not just the symptoms and aim to create a world where mental health is no longer stigmatized or marginalized, but rather is embraced as an integral part of one's overall well-being. Rula is a remote-first company that values diversity, equity, and inclusion.
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.
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.
Manages the entire lifecycle of payer enrollment, credentialing, and re-enrollment of healthcare providers and facilities.
Maintains provider databases, ensuring accurate, timely submission of documentation to secure billing privileges and network participation.
Resolves claim denials, verifying insurance and performing billing related tasks to ensure timely and accurate reimbursement.
Plumas District Hospital (PDH) provides compassionate care with exceptional customer service. They are located in Quincy, California with a team that puts community first.
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.
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.
Own the day-to-day tracking and progress of clinician credentialing and payer enrollment workflows.
Identify and resolve blockers across credentialing, enrollment, and re-credentialing processes.
Support clinicians directly by guiding them through credentialing and enrollment requirements.
Wheel is evolving the traditional care ecosystem by equipping companies with a premier platform to deliver virtual care at scale. They offer strategies and technologies to foster consumer engagement, build brand loyalty, and maximize return on investment.
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.
Responsible for coding procedures and entering charges to comply with regulations and internal policies.
Coordinate with Practice Coordinator and Revenue Integrity to assure necessary documentation is present.
Participates in audits to evaluate code accuracy and develops methodologies to improve coding issues.
Northside Hospital is an award-winning and state-of-the-art healthcare provider that is continually growing. By constantly expanding the quality and reach of our care we hope to create even more opportunity for the best healthcare professionals in Atlanta and beyond.
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.
Follows documented process to ensure timely processing of Primary Source Verification completion for initial and recredentialing.
Follows guidelines in alignment with all NCQA, CMS, and state requirements as related to the provider credentialing.
Works with both internal and external stakeholders to resolve complex provider credentialing issues.
Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers
Conduct thorough research on attributed patients to better understand their healthcare needs and utilization.
Perform telephonic outreach to the caregivers of attributed patients with the goal of enrolling their child in care and ensuring a seamless onboarding experience.
Collaborate with Provider Engagement Specialists to conduct embedded outreach to support the enrollment process.
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 to break down barriers to quality care.
Support the Medical Staff Services Credentialing team.
Collect, verify, and maintain accurate records within the Credentialing system.
Perform other administrative duties as assigned.
Cooper University Health Care is committed to providing extraordinary health care. Their professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols.
Process new patient referrals and accurately enter patient information.
Communicate with payors, referral sources, and patients regarding documentation and eligibility.
Verify eligibility and benefits in a timely manner and maintain active authorizations.
Immersiv is a new medical infusion clinic company designed to enhance the experiences of providers and patients as they navigate the healthcare system. They aim to offer more than just medication, also providing access to vaccines and outcomes assessments.
Create a welcoming experience by authentically engaging every caller, every time.
Thoroughly and accurately answer questions about customers’ healthcare accounts.
Thoughtfully listen to callers’ needs and provide appropriate solutions.
Point C is a National third-party administrator (TPA) with local market presence that delivers customized self-funded benefit programs. They research the most effective cost containment strategies and are driving down the cost of plans with innovative solutions.
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.