United States onlyAbout Us: Artera is an AI startup that develops medical artificial intelligence tests to personalize therapy for cancer patients. Artera is on a mission to personalize medical decisions for patients and physicians on a global scale.
The Credentialing and Enrollment Coordinator will have direct experience managing group/facility credentialing for clinical laboratories, handling applications, and overseeing payer enrollment processes. This role will also be responsible for managing EDI (Electronic Data Interchange), ERA (Electronic Remittance Advice), and EFT ( Electronic Fund Transfer) enrollments with commercial and government payers, ensuring seamless electronic claim submission and payment workflows.
Essential 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.
Education and Experience 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.
Equal Employee Opportunity: At Artera, we value bringing together individuals from diverse backgrounds to develop new and innovative solutions for patients and physicians. As an equal opportunity employer, we do not discriminate on the basis of race, color, religion, national origin, age, sex (including pregnancy), physical or mental disability, medical condition, genetic information gender identity or expression, sexual orientation, marital status, protected veteran status, or any other legally protected characteristic.
