[Remote] Credentialing Specialist at Heartbeat Health

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Not SpecifiedCompensation

N/AExperience Level

N/AJob Type

Not SpecifiedVisa

N/AIndustries

Requirements

High school diploma or equivalent required; Associate’s or Bachelor’s degree in Healthcare Administration or related field preferred
5-7 years of experience in healthcare credentialing and payer enrollment (telehealth or multi-state experience strongly preferred)
Strong knowledge of government and commercial payer enrollment requirements
Familiarity with RCM processes and how credentialing impacts reimbursement
Proficiency with credentialing platforms and payer portals (e.g., CAQH)
Excellent organizational skills with the ability to manage multiple providers and payers across states
Strong communication skills to build positive relationships with providers, payers, and revenue cycle teams

Responsibilities

Complete and manage all aspects of initial credentialing, re-credentialing, and payer enrollment for a large network of telehealth providers across the U.S
Submit and track applications with government payers (Medicare, Medicaid, VA, Tricare) and commercial/private payers to ensure active participation status
Lead and mentor credentialing staff, providing training, guidance, and quality checks
Serve as the subject matter expert (SME) for credentialing, payer enrollment, and their connection to revenue cycle processes
Optimize credentialing turnaround time and reduce payer enrollment delays that impact revenue
Stay up to date on payer regulations and credentialing requirements across all states where the organization provides telehealth services
Analyze denial trends related to credentialing/enrollment issues and implement corrective actions
Track payer roster accuracy and manage data integrity between credentialing systems and billing systems
Maintain accurate provider records in credentialing systems (e.g., CAQH, payer portals, internal databases), ensuring information is current and compliant
Verify provider credentials including education, training, board certification, work history, malpractice history, and references
Ensure provider enrollment aligns with billing requirements, reducing claim denials and reimbursement delays for a streamlined Revenue Cycle Management (RCM) process
Monitor payer rosters and enrollment timelines to proactively resolve issues that may impact revenue
Support the onboarding of new providers by ensuring credentialing and enrollment are completed prior to patient scheduling
Prepare reports on credentialing status, payer enrollment progress, and upcoming expirations for leadership and compliance purposes
Assist with audits, quality checks, and process improvements to ensure compliance

Skills

Heartbeat Health

Telehealth solutions for cardiovascular care

About Heartbeat Health

Heartbeat Health focuses on improving cardiovascular care through telehealth solutions. Their platform connects with cardiovascular clinics to provide real-time clinical data, enabling same-day diagnostic readings and virtual consultations for patients at moderate to high cardiovascular risk. This integration helps healthcare providers streamline their workflows and enhance patient engagement, making chronic disease management more effective. Unlike other telehealth services, Heartbeat Health specializes in cardiology, offering tailored solutions that improve patient outcomes. The company's goal is to create a modern cardiology ecosystem in the U.S. by making cardiovascular care more accessible and proactive.

New York City, New YorkHeadquarters

2017Year Founded

$54.4MTotal Funding

LATE_VCCompany Stage

Data & Analytics, HealthcareIndustries

51-200Employees

Benefits

Remote Work Options

Flexible Work Hours

Risks

Increased competition from companies like Cleerly could challenge Heartbeat Health's market share.

Potential regulatory changes in Medicaid policies may impact partnerships with MedArrive.

Rapid expansion may lead to operational challenges if not managed effectively.

Differentiation

Heartbeat Health offers virtual-first cardiovascular disease prevention and management.

The platform provides real-time diagnostics and virtual consultations for cardiovascular care.

Heartbeat Health integrates seamlessly with existing cardiovascular clinics for enhanced patient engagement.

Upsides

Recent investment from Cressey & Company will accelerate growth and enhance clinical offerings.

Partnerships with MedArrive and Karoo Health expand access to cardiology care and decentralized platforms.

Collaboration with Cleerly enhances AI-driven heart disease detection and patient outcomes.

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