Meet knownwell, weight-inclusive healthcare for all. Join a dynamic company that is changing the way obesity care is delivered. We offer weight management, primary care, nutrition counseling, and health coaching. Our care model combines in-clinic and virtual care to bring support to patients where and when they need it.
Backed by $50M in funding—including a $25M round led by CVS Health Ventures with support from a16z Bio + Health, Flare Capital, MassMutual, and Intermountain Ventures—we’re scaling fast and expanding access to evidence-based obesity care nationwide.
To achieve our ambitious goals, we're looking for a Payer Credentialing Specialist to join our Operations team. This role will support all things credentialing at knownwell, and play a critical role in building, shaping, and scaling our network so that all Americans have access to our services.
The ideal candidate is a managed care expert who has a successful track record in efficiently credentialing providers across a number of geographies. You will be most successful in this role if you have an ownership mindset, strong attention to detail, and a knack for managing multiple priorities.
You will:
- Manage end-to-end credentialing and recredentialing processes for new and existing providers, including verification of education, training, board certifications, and work history.
- Coordinate payer enrollment applications and updates to ensure timely processing and provider participation across commercial and government payers.
- Maintain accurate and up-to-date credentialing files and records in compliance with internal standards and regulatory requirements.
- Collaborate with providers, health plans, and internal departments to resolve any credentialing-related issues or delays.
- Track credentialing timelines and proactively follow up on outstanding applications or documentation.
- Ensure compliance with NCQA, CMS, state, and payer-specific regulations and standards.
- Participate in audits, surveys, and reporting related to provider credentialing and enrollment.
- Support cross-functional teams including clinical operations, revenue cycle, and human resources with credentialing-related information and processes.
You have:
- Minimum of 2 years of experience in provider credentialing and payer enrollment, preferably in a multi-state medical group or healthcare organization.
- Strong knowledge of CAQH, NPPES, PECOS, and insurance payer enrollment processes.
- Familiarity with credentialing standards from NCQA, The Joint Commission, and CMS.
- High level of accuracy and attention to detail.
- Excellent communication and interpersonal skills.
- Ability to work independently, manage multiple priorities, and meet deadlines in a fast-paced environment.
Pay & Perks:
- Fully remote opportunity