Foodsmart
Digital Health & Health Tech
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Collect, verify, and maintain provider credentials, including education, licensure, board certification, DEA registration, malpractice insurance, and work history
Conduct primary source verification (PSV) of licenses, certifications, and education through official sources
Support compliance efforts with regulatory and accrediting institutions
Maintain and update provider profiles in CAQH (Council for Affordable Quality Healthcare) through the Group Profile
Track credential expiration dates and proactively initiate renewals for licenses, CDRs, DEA registrations, board certifications, and malpractice coverage, as applicable
Prepare providers for credentialing committee review and respond to requests for additional information
Conduct/review background checks, National Practitioner Data Bank (NPDB) queries, and OIG/SAM exclusion list checks, etc.
Maintain compliance with NCQA, CMS, or state-specific credentialing standards
Help manage communication with providers, insurances, and related entities
Enroll providers with Medicare, Medicaid, and commercial insurance payers
Complete and submit payer enrollment applications
Track application status and follow up with payers to resolve delays or denials
Link providers to group practices and tax ID numbers with appropriate payers
Process provider terminations, updates, and re-validations with payers
Coordinate effective dates of enrollment with billing and revenue cycle teams to avoid claim denials
Support the interpretation of basic policies and procedures
Input provider information into credentialing/enrollment databases and systems
Maintain data accuracy and confidentiality
Assist in generating basic reports related to credentialing and enrollment
Help manage communication with providers, insurances, and related entities
Provide customer service support and help respond to inquiries
Support provider education efforts on enrollment requirements
Minimum of 1 year of experience in Medicare and/or Medicaid enrollment, with foundational knowledge of related processes
Familiarity with CAQH, PECOS, NPPES, and state-specific enrollment portals
Working knowledge of medical terminology and healthcare/CMS regulations
Proficiency in data entry and management software
Strong organizational and time management skills, with demonstrated attention to detail
Proven ability to manage multiple complex projects and consistently meet deadlines
Excellent written and verbal communication skills
Ability to work both independently and collaboratively within a team environment
About our benefits and perks:
✅ Remote-First Company
✅ Unlimited PTO
✅ Flexible & remote location
✅ Healthcare Coverage (Medical, Dental, Vision)
✅ 401k & bonus
✅ Registered Dietitian Sessions
Foodsmart is an Equal Opportunity Employer. It is our firm policy to extend equal employment and advancement opportunity to all applicants and employees without regard to race, color, national origin, citizenship status, religious creed, age, sex (including pregnancy, childbirth, breastfeeding, medical conditions related to pregnancy, childbirth and/or breastfeeding), gender, gender identity and expression, sexual orientation, marital status, disability (physical or mental) and/or a medical condition, genetic information, ancestry, veteran status or service in the uniformed services, and any other characteristic protected by applicable federal, state or local law.
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