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Credentialing & Enrollment Specialist

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Location
United States
Verifiable

Job Description

About Us:
Verifiable provides industry-leading, API-first solutions to automate credentialing and provider network management for the healthcare industry. Our software is used by some of the largest and fastest growing healthcare companies like Humana, TriWest, Spring Health, Modern Health, Talkspace and Grow Therapy. We are an official Salesforce vendor, and the #1 fastest-growing ISV partner on the Salesforce app exchange in 2023.
About You: Our credentialing team is core to our business and is responsible for helping our clients credential their providers so patients can receive care safely & as soon as possible. In this role, you'll be working with clients at the forefront of the healthcare, credentialing a variety of provider types across multiple states. You’re a great fit for this role if you love the details of credentialing, primary source verification, and working to credential multiple provider types in a fast paced environment. Ideally, you are also highly motivated by doing high-quality, efficient work for clients across the healthcare industry. We also hope you also are excited about the opportunity to shape what credentialing looks like and you thrive working with a close-knit, collaborative team.

What You'll Own & Improve:

  • This role will provide the unique opportunity to cross-train on both Credentialing & Payer Enrollment work

  • For the first year of your work with Verifiable, you will be working with 1-2 clients who primarily need Payer Enrollment support (submitting individual applications to public and private payers like Medicare, Medicaid, Cigna, BCBS, etc.)
  • You will own ensuring that payer enrollments are submitted and approved timely.
  • You will manage outreach to payers for follow-up and providing regular, detailed updates to our customers on the status of enrollment applications.
  • You will meet regularly with the client to provide them with updates

  • After the first 6 months - 1 year, your primary focus will shift to Credentialing
  • Credentialing providers end-to-end, at times managing high volumes of credentialing caseloads
  • Pioneering best practices & new workflows to manage provider credentialing
  • Collaborating cross-team, with both internal and external stakeholders, to continuously improve the way we work
  • Research to define our policies, procedures, and processes
  • An eye for streamlining processes and best practices to make the messy world of healthcare provider credentialing more organized.

What you already know:

  • You have experience successfully enrolling providers with public and private payers.
  • You have 1+ years of relevant Credentialing Management experience (i.e Physicians, Advanced Practice Providers) and ideally are familiar with NCQA standards.
  • You are a clear communicator with excellent attention to detail, organization, and prioritization skills
  • You are incredibly professional and champion high-levels of customer service
  • You have professional experience utilizing tools Google Suite (Gmail, Google Docs) and Adobe (even better if you’ve used Salesforce or a comparable CRM tool before)
  • You work fast and love the healthcare tech industry
  • You’re a professional through and through, and can work effectively with a wide range of stakeholders through both verbal & written communication.
  • You’re able to balance more than one responsibility at a time, and enjoy a day that blends solo heads-down work alongside collaboration with a team.
This role is only available for employees based in the following states: Arizona, Florida, Georgia, Idaho, Kentucky, Maryland, Michigan, New Jersey, New Mexico, North Carolina, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Utah
More About Verifiable:
-We’ve grown to over 100 employees in 5 years. Steady revenue growth allowed us to secure a $27M Series B led by Craft Ventures, bringing us to $47M in total funding.
-We value the many benefits of remote work, so we’re fully distributed across the US and internationally.
-Benefits include Health/Vision/Dental plans, unlimited PTO, new Apple equipment, and startup equity as part of your comp package.

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About the job

Sep 14, 2024

Full-time

  1. US United States
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