Senior Manager, Credentialing & Enrollment
Imagine PediatricsSalary not specified
Full Time
Expert & Leadership (9+ years)
Not SpecifiedCompensation
N/AExperience Level
N/AJob Type
Not SpecifiedVisa
N/AIndustries
Requirements
- Associates degree required
- 2 or more years of experience in credentialing and payer enrollment, preferably in a clinical laboratory
- Strong knowledge of Type 2 NPI credentialing and enrollment processes with Medicare, Medicaid, and commercial payers
- Hands-on experience with EDI, ERA, and EFT enrollment and troubleshooting
- Familiarity with payer portals, PECOS, and clearinghouse platforms
- Excellent organizational skills with the ability to manage multiple projects and deadlines
- Strong written and verbal communication skills
Responsibilities
- Coordinate credentialing and re-credentialing activities for the laboratory
- Prepare and submit payer applications, contracts, and supporting documents
- Track enrollment status with Medicare, Medicaid, and commercial payers
- Maintain accurate records of credentialing and enrollment activities
- Initiate and manage EDI, ERA, and EFT enrollment requests with payers
- Coordinate with clearinghouse and payers to troubleshoot transmission issues
- Ensure all electronic connections are tested and verified for claims and remittances
- Ensure compliance with payer-specific requirements and regulations
- Maintain up-to-date provider files and documentation for audits and reporting
- Monitor credentialing and enrollment deadlines to prevent lapses in participation
- Serve as a point of contact for payers, providers, and internal teams regarding credentialing and enrollment status
Skills
Artera
SaaS digital health messaging integration platform
About Artera
Artera is a compelling workplace due to its critical role in improving healthcare communication, orchestrating over 2.2 billion messages annually across diverse channels like texting, email, and webchat. The company not only facilitates efficient healthcare staff operations and profitability for organizations but also enhances overall patient experience by supporting services in over 109 languages. This broad impact in healthcare through high-level integration with EHRs and third-party vendors positions Artera as a leader in the digital health sector.
Santa Barbara, CaliforniaHeadquarters
2015Year Founded
$148.4MTotal Funding
SERIES_CCompany Stage
AI & Machine Learning, HealthcareIndustries
201-500Employees