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.
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 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.
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.
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.
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.
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 the credentialing process for clinical team members across multiple healthcare facilities.
Ensure all required documentation including licenses, certifications, and background checks is complete and up to date.
Serve as a point of contact between healthcare facilities and the credentialing team to address inquiries and provide updates.
VIC the PICC is a specialized healthcare provider focused on vascular access consulting services to acute care hospitals, skilled nursing facilities, and home healthcare. We emphasize a supportive culture with core values of integrity, respect, and compassion.
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.
Process hospital privilege applications for clinicians and communicate with medical staff offices for status updates.
Maintain credentialing database, document all communications, and conduct follow-up on application status.
Respond to inquiries, escalate issues, and develop relationships with medical staff offices.
Pediatrix Medical Group is one of the nation's largest providers of prenatal, neonatal, and pediatric services. They are an innovative company focused on a team approach to improve patient lives, offering diverse opportunities and a commitment to clinical excellence.
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.
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.
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.
Manage the full Authorization process, from initial notification to determination and discharge, with detailed documentation in EMR and payer systems.
Verify patient eligibility and benefits, act as a liaison between hospital staff and health payers, and track pending authorizations for timely responses.
Maintain HIPAA compliance, escalate issues causing delays or denials, and manage workloads through accurate record keeping.
CorroHealth is a partner to healthcare providers, solving revenue cycle challenges through a mix of services, consulting, and technology. The company focuses on scalability and clinical expertise, building long-term careers by investing in employee development.
Conduct benefit investigations, insurance verification, and prior authorizations to secure timely patient access to therapies.
Manage patient case files, coordinate product ordering and shipment with pharmacies and prescribers.
Handle inbound inquiries, report adverse events, and educate stakeholders on program requirements.
Jobgether is a platform that uses AI-powered matching to connect candidates with hiring companies. They focus on efficient, objective candidate screening and share top-fitting shortlists with employers.
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.
Manage high-value medical claims, denials, and appeals to ensure accurate and timely reimbursement.
Analyze unpaid/underpaid claims, investigate billing errors, and communicate with insurance payors via portals, phone, and email.
Maintain detailed documentation, process updates, and collaborate with internal teams to resolve complex accounts receivable issues.
Our partner operates within the healthcare revenue cycle, ensuring accurate reimbursement for medical services. They are a collaborative team focused on improving financial outcomes and maintaining compliance with healthcare regulations.
Research payer requirements and establish new direct or trading partner connectivity solutions.
Maintain payer connectivity data and serve as subject matter expert and escalation point for connectivity issues.
Partner with cross-functional teams to support setup, troubleshooting, and optimization of payer connections.
Experian is a global data and technology company that uses data, analytics, and software to power opportunities across lending, fraud prevention, healthcare, and digital marketing. With 23,300 employees across 32 countries, it fosters an inclusive culture focused on work/life balance, development, and recognition.
Lead managers and supervisors responsible for member enrollment and billing operations.
Drive achievement of client SLAs, quality metrics, productivity, and financial targets.
Partner with clients and internal stakeholders to identify operational improvements and foster a culture of accountability.
Sutherland leverages artificial intelligence, automation, and cloud engineering to drive digital transformation for iconic brands. With over 200 patents and a focus on human-machine collaboration, the company delivers measurable results through a seamless 'as a service' model.