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.
Showcase customer service and data entry skills as part of the healthcare team.
Involved in claims adjudication and/or provider credentialing.
Support customers by phone, email and chat.
Sutherland helps customers globally achieve greater agility and transform automated customer experiences. As a digital transformation company they have been in business for over 35 years and are Great Place to Work certified with nearly 40,000 employees.
Prepare and submit credentialing and enrollment packets.
Maintain accurate provider files and track expirations.
Provide assistance to the billing team during staff absences.
Modena Health and Modena Allergy & Asthma are leading medical practices specializing in allergy, asthma, and immunology care, with clinics across Southern California and Arizona and plans for national expansion. They are physician-led and technology-enabled, committed to transforming allergy care while advancing clinical research and expanding access to cutting-edge medicine.
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.
Own the end-to-end cycle of credentialing applications for new and existing providers under our contracts, ensuring all requirements are met for successful enrollment.
Assist in building NCQA compliant ongoing monitoring and delegation programs for the Nourish network of RDs.
Support efforts to streamline existing credentialing processes by providing suggestions for automation or new tools, optimizing individual steps, and ensuring smooth workflows.
Nourish is on a mission to improve people’s health by making it easy to eat well. They are building an AI-native, patient-friendly healthcare system centered on nutrition that improves outcomes, lowers costs, and helps people live healthier, longer lives. Nourish launched three years ago, are live in all 50 states, and already have thousands of dietitians and hundreds of thousands of patients on the platform.
Support clinical staff by gathering data to complete the medical necessity review process.
Create and send letters to providers and/or members to communicate information.
Collaborate with care management teams and stakeholders to provide optimal service.
Wellmark is a mutual insurance company owned by policy holders across Iowa and South Dakota, and they’ve built their reputation on over 80 years’ worth of trust. They are motivated by the well-being of their members, putting them first and committing to sustainability and innovation.
Support providers and patients by managing administrative tasks.
Ensure compliance, coordination, and continuity of care.
Manage documentation related to tele-mental health services.
Valera Health is at the forefront of tele-mental health, committed to delivering compassionate mental health care that is accessible and affordable. The company employs a comprehensive care approach, combining therapy and medication management with overall wellness promotion to ensure patients are supported.
Provide accurate assistance to support the administrative needs of Brokers and Admins across phone and email.
Assist with the administrative side of onboarding and system needs for new and renewing Sana plans.
Address and resolve complaints or problems, such as billing discrepancies and coverage denials.
Sana is a health plan solution built for small and midsize businesses — designed around their integrated primary care service, Sana Care. They've been remote-first since day one, with a fully distributed team across the U.S., and value curiosity, ownership, and speed—building in the open, together.
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.
Maintain oversight over a specified panel of members by performing ongoing assessments.
Create comprehensive care plans addressing members' needs and conducting regular follow-ups.
Ensure achievement of targeted goals related to patient outcomes and care plan realization.
Jobgether is a company that uses an AI-powered matching process to ensure applications are reviewed quickly, objectively, and fairly against the role's core requirements. Their system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company.
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.
Manage prior authorizations and related administrative paperwork.
Input patient information, medical records (CPT, ICD-10, HCPCS), and billing data into EMR/EHR systems.
Assist with processing insurance claims, verifying patient insurance information, and handling billing inquiries, concerns, and documentation.
Wing is redefining the future of work for companies worldwide. They aim to be a one-stop shop for companies looking to build world-class teams and place their operations on autopilot.
Team members will perform outbound calls to enroll the person into their food box program or to reauthorize the person into the program.
Have a passion for helping members make decisions that will enhance their healthcare experience
You will be making a difference in someone’s life!
Carenet Health has pioneered advancements for an experience that touches all points across the healthcare consumer journey. They interact with 1 in 3 Americans every day, delivering positive healthcare experiences and improving outcomes.
Gather, validate, and prepare data from multiple sources.
Identify missing or inconsistent fields and partner with Operations to resolve issues.
Zócalo Health is the first tech-driven provider built specifically for Latinos, by Latinos, developing a new approach to care designed around shared and lived experiences. Founded in 2021, they are backed by leading healthcare and social impact investors.
Auditing incoming applications to ensure all required information is documented.
Handling multiple applications simultaneously with using BPM, Cactus, CAQH, and Facets.
Communicating effectively with providers and internal teams to resolve any issues and ensure smooth operations.
BlueCross BlueShield of Tennessee has been helping Tennesseans find their own unique paths to good health since 1945. At BCBST, they empower their employees to thrive both independently and collaboratively, creating a collective impact on the lives of their members.
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.
Execute payer enrollment applications from credentialing approval through payer confirmation.
Coordinate CAQH profile maintenance and attestations in alignment with Medallion workflows and payer requirements.
Track enrollment status, follow up with payers, and escalate delays or issues to the Payer Enrollment Manager.
Spring Health aims to eliminate barriers to mental health by delivering the right care at the right time through their clinically validated technology, Precision Mental Healthcare. They partner with over 450 companies and are valued at $3.3 billion.
Support daily operations for assigned facilities under Dozee’s Remote Patient Monitoring (RPM) program.
Ensure patients are fully onboarded, qualified, and tracked for billing readiness through consistent monitoring.
Maintain compliance and maximize revenue outcomes.
Dozee Health AI is a pioneer in Contactless Remote Patient Monitoring (RPM), proven to drive transformation at scale. Headquartered in Bengaluru, India, Dozee has emerged as India’s no. 1 RPM company with 280+ employees.
Provide accurate information on health plan benefits, eligibility, and claims.
Handle inbound/outbound calls and respond to email inquiries.
Deliver an exceptional customer service experience to members and providers.
Evry Health's mission is to bring humanity to health insurance. Their high-technology health plans expand benefits, increase access and transparency, and feature a personalized, human approach. Evry Health is the major medical division of Globe Life (NYSE:GL).
Serve as a facilitator between the patient and the company, ensuring a seamless experience.
Answering questions about the company, offering accurate information about our products and services.
Ensuring patient satisfaction and maintaining professional patient support.
Willow is a telehealth company focused on personalized, responsible cosmetic weight loss care. They combine medical expertise with a supportive, patient-centered approach to help people feel more confident.
Collect, review, and track required documentation from caregivers and families.
Make outbound calls and respond to inbound inquiries to guide families through the documentation process.
Handle a high volume of phone interactions daily while maintaining professionalism, empathy, and efficiency.
Abby Care is making family care possible by training and employing family caregivers so they can get paid for the care they already provide at home. They are building a tech-powered, family-first care platform to improve health outcomes, and provide the best-in-class experience nationwide.