Serve as the primary point of contact for dental providers and network partners, resolving escalated issues related to claims, credentialing, authorizations, payments, and plan-specific benefit questions.
Act as the bridge between providers and internal operations, claims, and client services teams to resolve issues quickly and prevent repeat problems.
Coordinate with claims, credentialing, contracting, and client services teams to resolve cross-functional issues and support compliance requirements.
Prepare and review credentialing and recredentialing applications, provider updates, termination letters, and TIN change documents.
Conduct biweekly follow-up with payers, track application progress, and maintain detailed records in internal systems and dashboards.
Support team projects such as new provider onboarding, payer roster updates, and quality reviews while protecting confidential information.
Specialty Dental Brands is a dental support organization that partners with pediatric dentistry, orthodontics, and oral surgery practices across the country, empowering teams with technology, resources, and support. The company values a people-first culture, collaboration, continuous learning, and creating positive experiences for providers, practices, and employees.
Researches and resolves provider payer enrollment issues with CMS and other payers.
Manages completion and submission of Medicare, Medicaid, and third-party applications.
Tracks revalidation dates and maintains provider demographics in enrollment systems.
Ventra is a leading business solutions provider for facility-based physicians, focusing on Revenue Cycle Management. They partner with private practices and hospitals to deliver data-driven solutions, fostering a collaborative culture with a performance-based incentive plan.
Help members navigate US health insurance, including billing questions, denied claims, and appeals.
Coordinate with providers, insurers, and members to resolve coverage issues and prior authorizations.
Translate complex insurance benefits into clear guidance and identify trends to improve the member experience.
This company provides a global safety net for remote workers, offering health, income, and travel coverage. It operates as a remote-first organization with a culture of empathy, integrity, and a mission to improve access to healthcare worldwide.
Build and maintain a network of specialist consultants and physicians to refer patients to clinical studies.
Identify opportunities to expand the local physician database and increase practices working with Care Access.
Maintain strong relationships with physicians and ensure high-quality customer service across the region.
Care Access brings clinical research and health services directly to communities through hundreds of locations and mobile clinics. They are dedicated to making the future of health better and more accessible for all.
Own the end-to-end process for enrolling new providers with health plan partners.
Work closely with new clinical hires and third-party vendor to manage license applications and renewals.
Identify opportunities to improve licensing, credentialing, and enrollment processes to shorten time for clinicians to start seeing patients.
Pomelo Care is a virtual medical practice providing proactive, 24/7 clinical care for women and children across pregnancy, postpartum, pediatrics, menopause, and perimenopause. The company is a well-funded startup with a collaborative, data-driven culture focused on improving outcomes for all mothers and babies.
Manage provider data and generate reports to support network operations and compliance.
Validate and audit provider records to ensure data accuracy and regulatory alignment.
Collaborate with cross-functional teams to resolve configuration issues and support network projects.
This company operates in the healthcare sector, focusing on provider network administration and data management. It fosters a collaborative, detail-oriented remote work environment that values data accuracy and continuous quality improvement.
Accurately review, process, and adjudicate health insurance claims in compliance with company policies and regulatory requirements.
Resolve system edits, audits, and claims errors through research and approved references.
Contribute to team-wide goals by processing claims and reducing daily inventory.
Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started in 2012 to create the kind of health insurance company we would want for ourselves, and we are a growing team committed to changing health care.
Own benefits scheme setup, renewals, and policy events from start to resolution.
Build and maintain insurer relationships to ensure accurate and timely outcomes.
Handle complex cases with accountability and clear communication.
Kota is a regulated, multi-country business that provides operations and benefits services. The company has around 100 employees in a growing, owner-driven culture.
Answer patient calls and texts, handle new patient inquiries using practice templates.
Manage scheduling, recare outreach, and follow-ups for overdue cleanings.
Support insurance verification, clean up patient records, and escalate complex issues.
Wing is a company that helps businesses build world-class remote teams and streamline operations. It fosters an inclusive, supportive culture with career growth, upskilling, and paid training opportunities.
Supports credentialing and enrollment teams by managing data across Monday.com, Airtable, and Credential Stream.
Drives process improvement initiatives and develops progress reports to keep stakeholders informed.
Collaborates with enterprise stakeholders to maintain accurate data sharing and best practices.
United Vein & Vascular Centers is a leading provider of comprehensive vein and vascular care with over 60 clinics across multiple states. The company emphasizes minimally invasive procedures, cutting-edge technology, and a patient-centric approach to deliver superior outcomes.
Review and validate medical provider enrollment applications for accuracy and compliance.
Verify provider data via internal databases and external agencies, and set up EFT accounts.
Communicate with providers and departments to resolve discrepancies and provide application guidance.
Broadway Ventures transforms challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business, we empower clients with tailored solutions, built on integrity, collaboration, and excellence.
Manage end-to-end case activities for insurance verification, authorization, and reimbursement.
Serve as the single point of contact among patients, providers, payors, and internal teams.
Prioritize competing demands to ensure timely patient access to therapy.
PRO-Spectus supports patient services programs by navigating patient access from benefit verification through claims and reimbursement resolution. The company fosters a supportive, teamwork-driven culture focused on improving patients' lives.
Manage accounts receivable, including analysis of aged AR and identification of root cause issues.
Investigate, resolve, and appeal insurance claim denials, contacting payer representatives as needed.
Collaborate with internal teams and care center staff to drive optimal revenue cycle performance.
Privia Health is a technology-driven physician enablement company that partners with medical groups and health systems to optimize practices and improve patient experiences. It is led by top industry talent and physician leadership with a focus on scalable operations and cloud-based technology.
Manage provider system enrollments and maintain accurate CAQH profiles.
Serve as the primary credentialing point of contact for providers and monitor enrollment requirements.
Develop and maintain standard operating procedures for credentialing workflows.
Sailor Health is revolutionizing mental health care for older adults, addressing one of the fastest-growing and most underserved healthcare segments in America. As a remote-first team, they focus on providing compassionate, effective care to over 60 million seniors, fostering a culture of growth, ownership, and collaboration.
Serve as the primary day-to-day operational contact for assigned employer and health plan clients, ensuring high service and support.
Build positive working relationships with client contacts including HR teams, benefits administrators, and consultants.
Monitor account performance metrics, pharmacy spend, and utilization trends to surface insights and optimization opportunities.
AffirmedRx is on a mission to improve health care outcomes by bringing clarity, integrity, and trust to pharmacy benefit management. They are committed to making pharmacy benefits easy to understand and straightforward to access, and they promise to do what's right, always.
Manage a team of licensing and credentialing specialists, overseeing end-to-end provider enrollment with states and health plans.
Own the enrollment strategy across clinical specialties, payers, and geographic states to ensure coverage for midlife patients.
Leverage data to proactively identify gaps in process and clinician coverage, driving process improvements.
Pomelo Care is a leading virtual medical practice for women and children, offering comprehensive care across pregnancy, postpartum, pediatrics, menopause, and perimenopause. It is a fast-moving, well-funded startup with a collaborative, patient-first culture.
Provides administrative support to clinical teams including building medical management records and managing authorizations.
Conducts fax and telephonic outreach to members and providers for status updates and engagement.
Supports compliance monitoring and documentation in the medical management system.
Capital Blue Cross is a health insurance provider dedicated to improving the health and well-being of its members and communities. They are recognized as one of the "Best Places to Work in PA" with a culture focused on support, flexibility, and community involvement.
Support the full credentialing lifecycle, from initial applications to renewals and ongoing maintenance.
Manage provider enrollment processes with payers, including application submission, follow-up, and status tracking.
Keep provider records accurate and audit-ready while ensuring compliance with regulatory standards.
Thyme Care is a market-leading value-based oncology care enabler that partners with health plans, providers, and employers to improve outcomes for people with cancer. It is a tech-native startup that values human connection, diversity, and inclusion.
Lead the administrative engine behind payer contracts, membership, payment distribution, and client services for IPA operations.
Partner with IPA leadership and cross-functional teams to drive strategic initiatives and value-based care performance.
Mentor and manage a team including Operations Specialists and Membership Associates, while coordinating payer meetings and reporting.
Aledade PBC is a public benefit corporation that empowers independent primary care practices to thrive in value-based care. Founded in 2014, it has grown into the largest network of independent primary care in the U.S., with a collaborative, remote-first culture.
Respond promptly to provider inquiries and troubleshoot issues to ensure a smooth experience.
Document interactions accurately and escalate workflow issues to internal teams.
Collaborate with internal departments and participate in team meetings to maintain high-quality support.
OneImaging offers a concierge radiology service with a network of over 5,000 providers across 48 states, reducing imaging costs by 60-80%. The company is focused on delivering exceptional provider and patient experiences with a collaborative and supportive culture.