Vital Chain

Associate, Payor Credentialing & Contracting

Posted 5 Days Ago

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Hiring Remotely in Remote, OR

Remote

Junior

The Role

The Associate in Payor Credentialing and Contracting will coordinate provider enrollment, ensuring proper contracting and credentialing with health plans. Responsibilities include tracking enrollment applications, researching reimbursement guidelines, maintaining provider profiles, and improving credentialing processes. The role demands strong communication skills and experience in handling sensitive information.

Summary Generated by Built In

Associate, Payor Credentialing and Contracting
To continue providing accessible and affordable health care for all, Thirty Madison is growing our network of medical insurance partners alike. As our Associate, Payor Credentialing and Contracting, you will be working within our Revenue Cycle team in coordinating and executing provider enrollment from start to finish. You will be responsible for ensuring our medical providers are appropriately contracted and credentialed with health plans; providing quality control for the end-to-end provider enrollment process; and giving internal feedback on our network adequacy. You will be a subject matter expert in all things health plan contracting and credentialing. This role will be heavily external-facing and you must be comfortable interacting, communicating, and working directly with healthcare professionals and payors. Above all, you embody the Thirty Madison mission of providing access to healthcare for all who suffer from chronic conditions.
Comp | Perks | Benefits 
<ul>
<li>The base pay range for this position is $$52,400-$72,050 per year **</li>
<li>Annual Incentive Plan + Stock Option Package</li>
<li>Robust and affordable Health, Dental, and Vision plan options </li>
<li>401k with a match, commuter benefits, and FSA</li>
<li>Annual $750 vacation stipend and $500 happiness stipend</li>
<li>Flexible time off policy </li>
</ul>
**Base pay offered may vary depending on job-related knowledge, skills, and experience. An annual incentive plan and stock options may be provided as part of the compensation package, in addition to a full range of medical, financial, and/or other benefits, dependent on the position offered.
What you get to do every day
<ul>
<li>Submitting, tracking progress, and following up on health plan enrollment applications and credentialing processes for our full healthcare professional roster</li>
<li>Researching payor reimbursement guidelines to ensure Thirty Madison’s clinical models will be reimbursed</li>
<li>Maintaining accurate provider profiles on CAQH and internal databases</li>
<li>Leveraging payer portals, Availity, and other tools to efficiently follow up on providers’ credentialing status and progress</li>
<li>Providing input on our contracting roadmap based on state-regulated telehealth guidelines and Thirty Madison footprint</li>
<li>Handling confidential administrative functions like written external correspondence and primary document collection and verification</li>
<li>Showcasing payor credentialing expertise by giving input on how to improve and scale our credentialing processes</li>
<li>Other duties as assigned </li>
</ul>
What you bring to the role
<ul>
<li>2 or more years of payor credentialing and contracting experience </li>
<li>A high level of interpersonal skills to handle sensitive and confidential communications. In this externally-facing role, we require demonstrated poise, tact and professionalism.</li>
<li>Proficiency in word processing, spreadsheets, database and presentation software (Microsoft Suite/Google Suite, CAQH)</li>
<li>A general understanding of CMS, health insurance, and provider enrollment</li>
<li>An inclination towards process-oriented solutions and attention to detail</li>
</ul>
All Company policies and procedures are subject to change without notice based on business needs. This includes, but is not limited to, the locations where we hire remote, hybrid, or onsite employees.<div class="content-conclusion">U.S. Applicants Only
Don’t meet every single requirement? Studies have shown that women and people of color are less likely to apply to jobs unless they meet every single qualification. At Thirty Madison we are dedicated to building a diverse, inclusive and authentic workplace, so if you’re excited about this role but your past experience doesn’t align perfectly with every qualification in the job description, we encourage you to apply anyways. You may be just the right candidate for this or other roles.
We are proud to be an equal opportunity workplace committed to building a team culture that celebrates diversity and inclusion.
We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions. Contact us at <a href="mailto:[email protected]" target="_blank">[email protected]</a> to request accommodation.
<h4>About Thirty Madison </h4>
Thirty Madison is a family of specialized healthcare brands devoted to creating exceptional outcomes for all. Each of its specialized brands is focused on a specific ongoing condition, and thoughtfully designed to support the unique needs of its community with personalized treatments and care; with <a href="https://c212.net/c/link/?t=0&l=en&o=3183133-1&h=253147352&u=http%3A%2F%2Fkeeps.com%2F&a=Keeps" target="_blank" data-saferedirecturl="https://www.google.com/url?q=https://c212.net/c/link/?t%3D0%26l%3Den%26o%3D3183133-1%26h%3D253147352%26u%3Dhttp%253A%252F%252Fkeeps.com%252F%26a%3DKeeps&source=gmail&ust=1666374954486000&usg=AOvVaw32aTHFIj5fR9kApuDMe0hq">Keeps</a> for men's hair loss, <a href="https://c212.net/c/link/?t=0&l=en&o=3183133-1&h=2329199209&u=http%3A%2F%2Fwithcove.com%2F&a=Cove" target="_blank" data-saferedirecturl="https://www.google.com/url?q=https://c212.net/c/link/?t%3D0%26l%3Den%26o%3D3183133-1%26h%3D2329199209%26u%3Dhttp%253A%252F%252Fwithcove.com%252F%26a%3DCove&source=gmail&ust=1666374954486000&usg=AOvVaw1Jm9tg1v1F1HFVAyxzDjtm">Cove</a> for migraine,  <a href="https://facet.thirtymadison.com/" target="_blank">Facet</a> for skin conditions, and <a href="https://www.nurx.com/" target="_blank">NURX</a> for sexual health. With empathy at the heart of its innovation, its proprietary care model empowers hundreds of thousands of people with ongoing conditions with the accessible, effective treatments across a lifetime of care. In just four years, we’ve built a number of brands and are continuing to grow rapidly, recently raised a $140m Series C, and are backed by some of the best healthcare and consumer investors, including HealthQuest Capital, Mousse Partners, Bracket Capital, Polaris Partners, Johnson & Johnson, Maveron, Northzone, among others.
We are honored to become <a href="https://www.greatplacetowork.com/certified-company/7037076">Great Place to Work</a> certified and be included on BuiltIn's 2021 list of <a href="https://www.builtinnyc.com/companies/best-places-to-work-nyc-2021#thirty-madison">Best Places To Work in New York City</a>, and <a href="https://www.builtinnyc.com/companies/best-midsize-places-to-work-nyc-2021#thirty-madison">Best Midsize Companies To Work For</a>. We've also been recognized by <a href="https://www.forbes.com/lists/americas-best-startup-employers/?sh=6cb0c882ad72" target="_blank">Forbes' Best Startup Employers</a>, being named as one of <a href="https://www.forbes.com/companies/thirty-madison/?list=americas-best-startup-employers&sh=a0b43c29e5ce" target="_blank">America's Best Places to Work 2022.</a> This recognition is a true testament to our hardworking team and company culture. As we continue to grow, we pride ourselves on finding passionate individuals who truly embody our core values and mission each and every day. Learn more at <a href="http://thirtymadison.com/" target="_blank" data-saferedirecturl="https://www.google.com/url?q=http://thirtymadison.com/&source=gmail&ust=1666374954486000&usg=AOvVaw19hKS2nolK578gHj5TDy48">ThirtyMadison.com</a>. 
*This employer participates in E-Verify and will provide the federal government with your I-9 Form information to confirm that you are authorized to work in the U.S.*
*Please be aware that there are fraudulent entities who are falsely claiming to be or represent Thirty Madison in order to solicit sensitive personal information or payment. Thirty Madison is not in any way associated with these entities or practices. The safety and integrity of those seeking employment with us is of the utmost importance and we actively work with our legal and security teams to prevent future incidents. 
Thirty Madison will never ask for sensitive information or payment when engaging with job seekers. The entities use many methods to perpetuate these scams, including but not limited to: participating in a text-only interview, using Thirty Madison’s trademarks on their correspondence, or providing you with a seemingly legitimate offer letter. If you suspect you are a victim of this scamming, we encourage you to cease further contact and report the crime to <a href="https://reportfraud.ftc.gov/#/">The Federal Trade Commission</a>. </div>