The primary goal of this position is to manage the complex administrative and compliance-driven processes required for healthcare professionals to practice and for the organization to receive payment.Provider Credentialing (Verification and Compliance)Credentialing is the process of verifying a healthcare provider's qualifications to ensure they meet professional and regulatory standards. It's the quality control step.experience5
The primary goal of this position is to manage the complex administrative and compliance-driven processes required for healthcare professionals to practice and for the organization to receive payment.Provider Credentialing (Verification and Compliance)Credentialing is the process of verifying a healthcare provider's qualifications to ensure they meet professional and regulatory standards. It's the quality control step.experience5
1. End-to-End Enrollment Management● Manage the full-cycle payer enrollment and revalidation process for healthcare providers(Physicians, NPs, PAs, RNs, CRNAs, etc.).● Prepare, review, and submit enrollment applications across Commercial and/or Medicaidpayers.● Track application progress, follow up with payers, and maintain accurate, up-to-datedocumentation.2. Compliance & Regulatory Adherence● Ensure compliance with federal, state, and payer-specific
1. End-to-End Enrollment Management● Manage the full-cycle payer enrollment and revalidation process for healthcare providers(Physicians, NPs, PAs, RNs, CRNAs, etc.).● Prepare, review, and submit enrollment applications across Commercial and/or Medicaidpayers.● Track application progress, follow up with payers, and maintain accurate, up-to-datedocumentation.2. Compliance & Regulatory Adherence● Ensure compliance with federal, state, and payer-specific
Mission of the RoleTo function as the senior-most expert in payer enrollment, providing deep domain leadership, resolving complex escalations, driving process improvements, and enabling the overall team through knowledge development, training, and cross-functional collaboration.Core Responsibilities1. Domain Leadership & Expertise● Serve as the primary subject matter expert for all payer enrollment processes—Medicare (PECOS), Medicaid (state-specific),
Mission of the RoleTo function as the senior-most expert in payer enrollment, providing deep domain leadership, resolving complex escalations, driving process improvements, and enabling the overall team through knowledge development, training, and cross-functional collaboration.Core Responsibilities1. Domain Leadership & Expertise● Serve as the primary subject matter expert for all payer enrollment processes—Medicare (PECOS), Medicaid (state-specific),