Gather and maintain accurate provider data across multiple databases and systems.
Perform periodic provider data reconciliations with multiple data sources and generate reporting.
Support network development to ensure data integrity, accuracy, and completeness for network optimization.
Dignity Health Management Services builds a system-wide integrated physician-centric management service organization to coordinate patient care. As part of CommonSpirit Health, it offers a collaborative culture focused on improving quality of care and containing costs.
Review facility credentialing applications for accuracy and completeness based on applicable standards.
Communicate with facilities to resolve discrepancies and obtain missing information.
Manage data entry, monitor compliance, and prepare reports for the Credentialing Committee.
Curana Health is a national leader in value-based care for senior living communities and skilled nursing facilities. Founded in 2021, the company serves 200,000+ seniors across 1,500+ communities in 32 states with a team of over 1,000 clinicians and professionals, and was ranked #147 on the Inc. 5000 list.
Update and maintain provider file databases with submitted documentation.
Research and resolve provider contract file edits and claims issues.
Analyze reports for data corrections and ensure quality control of provider files.
Blue Cross Blue Shield of Arizona is a health insurance company dedicated to inspiring health and making it easy. With over 80 years of service and more than one million members, they offer a hybrid work environment called Workability that emphasizes flexibility.
Coordinate the end-to-end provider enrollment process, preparing and submitting applications to Medicare, Medicaid, and other payers.
Maintain accuracy of provider data in systems like NPPES, PECOS, and CAQH, and track facility privileging requirements.
Collaborate with internal teams to align enrollment timelines and ensure compliance with federal, state, and facility regulations.
Curana Health is a national leader in value-based care for older adults, providing primary care services and care coordination in senior living communities and skilled nursing facilities. Founded in 2021, the company serves over 200,000 seniors across 1,500+ communities and employs more than 1,000 clinicians, with a fast-paced, mission-driven culture.
Manage provider credentialing, licensing, and payer enrollment activities from application through completion.
Research and resolve non-routine credentialing and provider data discrepancies, ensuring compliance.
Maintain accurate provider records, monitor deadlines, and communicate with stakeholders to prevent delays.
The company is a partner organization that manages hiring for healthcare credentialing roles. They operate remotely and foster a collaborative, deadline-driven culture focused on compliance and operational excellence.
Enroll practitioners in health plans accurately and timely, monitoring progress and ensuring completion.
Validate and maintain provider enrollment forms, applications, and tracking systems.
Communicate with internal teams to meet enrollment goals and target start dates.
Pediatrix Medical Group is one of the nation's largest providers of prenatal, neonatal and pediatric services. With a focus on team approach, the company is home to a diverse group of business professionals dedicated to improving patient lives.
Research and maintain a proprietary database of elite healthcare providers to ensure accuracy and clinical relevance.
Expand the provider network through thoughtful evaluation and relationship development, supporting technology-enabled processes.
Partner with cross-functional teams to translate provider insights into actionable recommendations that improve client outcomes.
Private Health Management guides patients and families through serious medical care, providing independent advocacy and support. The company is a remote-first organization with a collaborative culture focused on improving healthcare outcomes.
Responsible for credentialing and recredentialing practitioner applicants to ensure regulatory compliance.
Conducts primary source verifications, reviews applications, and communicates with healthcare practitioners to obtain missing information.
Maintains credentialing database, monitors provider expirables, and assists with audit reviews.
Curana Health provides value-based care solutions, including on-site primary care, Accountable Care Organizations, and Medicare Advantage plans, to senior living communities and skilled nursing facilities. Founded in 2021, the company has grown to serve over 200,000 seniors across 1,500+ communities in 32 states, employing more than 1,000 clinicians and staff, and was ranked #147 on the Inc. 5000 list of fastest-growing private companies.
Accurately enter and update patient information in electronic charts and attach insurance documentation.
Verify and apply cancellation deposits to patient accounts while maintaining organized records across multiple locations.
Ensure confidentiality and compliance with privacy policies while identifying discrepancies and communicating issues.
We are a dental practice specializing in wisdom tooth extractions. We operate across 5 markets with 28 locations and maintain a culture focused on accuracy and confidentiality.
Collect, verify, and submit information necessary for enrollment of hospitals/physicians with Out-of-State Medicaid payers.
Develop and maintain ongoing policies and procedures specific to each state for new hospital/physician enrollments.
Manage work queue to ensure all timely submissions and deadlines of payor-specific forms and documents.
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified E360 RCM platform. The company is a multi-year recipient of the Top Workplaces award, recognized as Black Book's #1 Specialty Revenue Cycle Management provider in 2024, and has been among the top one percent of Inc. 5000 fastest-growing private companies for eleven years.
Contacting employers, insurers, and other entities via outbound calls, email, or fax to verify information for Motor Vehicle Accident claims.
Managing inbound and outbound calls, assisting in obtaining claim documentation, and filing insurance claims.
Performing accurate data entry, handling confidential documentation, and adhering to HIPAA guidelines.
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise. The company is a multi-year recipient of the Top Workplaces award and has been recognized as Black Book's #1 Specialty Revenue Cycle Management Solution provider in 2024.