Credentialing and Enrollment Coordinator

About us: Foodsmart is the leading telenutrition and foodcare solution, backed by a robust network of Registered Dietitians. Our platform is designed to foster healthier food choices, drive lasting behavior change, and deliver long-term health outcomes. Through our highly personalized, digital platform, we guide our 2.2 million members—including those in employer-sponsored health plans, regional and national Medicaid managed care organizations, Medicare Advantage plans, and commercial insurers—on a tailored journey to eating well while saving time and money. Foodsmart seamlessly integrates dietary assessments and nutrition counseling with online food ordering and cost-effective meal planning for the entire family, optimizing ingredients both at home and on the go. We partner with national and regional retailers across the U.S., many of whom accept SNAP/EBT, making healthier food more accessible. Additionally, we assist members with SNAP enrollment and management, providing tangible access to nutritious food. In 2024, Foodsmart secured a $200 million investment from TPG’s Rise Fund, which supports entrepreneurs dedicated to achieving the United Nations’ Sustainable Development Goals. This investment will help us expand our reach, particularly to low-income workers who are disproportionately affected by diet-related diseases. At Foodsmart, our mission is to make nutritious food accessible and affordable for everyone, regardless of economic status. We are committed to a set of core values that shape our culture and work environment: 👥 Customer First - You start with the member and work backwards. 🚀 Make It Happen - You act with urgency, use data, and hold high standards. 🤝 One Team - You collaborate with respect and commit as a group. Whether you're a dietitian, a commercial leader, or a technologist, working at Foodsmart means being part of a team that is passionate, supportive, and driven by a shared purpose. Join us in transforming the way people access and enjoy healthy food. About the role: The Credentialing and Enrollment Coordinator supports the healthcare provider compliance process by verifying provider qualifications and managing the enrollment of groups and providers with government and commercial insurance payers. This role ensures providers are properly credentialed and enrolled in a timely, accurate, and compliant manner, minimizing delays in providers' ability to see patients and bill for services. The ideal candidate is highly detail-oriented, organized, has a deep understanding of Medicaid and Medicare group and provider enrollment processes, and comfortable navigating multiple credentialing and payer systems while communicating and collaborating professionally with providers, team members, and payer representatives. The Credentialing and Enrollment Coordinator will work closely with the Credentialing and Enrollment Team, Clinical Operations department, and clinical staff to uphold the standards of professional practice and regulatory compliance such as CMS, NCQA, PECOS, with a primary focus on supporting the credentialing and enrollment of registered dietitians and other healthcare providers. This position offers an opportunity to gain a higher level of experience in healthcare administration while supporting the credentialing and enrollment processes. The ideal candidate will be detail-oriented, eager to learn, and possess strong organizational skills to assist in maintaining the quality of healthcare services. Candidates must reside in and work within the US. You Will: 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 You Have: 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 Commitment to maintaining confidentiality of sensitive information 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.