Description

You will join the credentialing/provider enrollment team to ensure providers are credentialed and enrolled quickly and accurately with health plans and hospitals, so patients have uninterrupted access to care. This hands-on role involves completing applications, resolving issues with payers, and maintaining high data quality in a growing AI-native healthcare company.

Requirements

• Bachelor’s degree in healthcare administration, business, or related field (preferred).
• 3+ years of experience in provider credentialing.
• Strong knowledge of NCQA standards, payer requirements, and credentialing best practices.
• Excellent problem-solving and critical thinking skills.
• Exceptional organization skills and attention to detail.
• Strong written and verbal communication and interpersonal skills.
• Experience with credentialing software and databases (preferred).

Responsibilities

• Work amongst a team of credentialing/enrollment specialists to deliver accurate, timely, and compliant work.
• Process credentialing, re-credentialing, and privileging applications.
• Solve enrollment-related issues directly with health plans.
• Monitor application timelines to prevent delays and resolve escalated issues.
• Maintain high data quality on provider and credentialing data.
• Follow SOPs and policies to streamline workflows and strengthen compliance.
• Maintain compliance with state, federal, and payer-specific credentialing requirements.
• Act as a liaison for external partners including payers, hospitals, and credentialing verification organizations.