Full-Time

Credentialing and Payer Enrollment Manager

Posted on 9/20/2024

Affect Therapeutics

Affect Therapeutics

51-200 employees

Digital platform for addiction recovery support

Healthcare

Senior

No H1B Sponsorship

Remote in USA

Category
Quality Control & Compliance
Operations & Logistics
Required Skills
Communications
Requirements
  • Bachelor’s degree in healthcare administration, business, or a related field.
  • Minimum of 5 years of experience in healthcare credentialing and payer enrollment.
  • Strong knowledge of payer requirements, including Medicare, Medicaid, and commercial insurance.
  • Excellent organizational and time management skills.
  • Strong communication and relationship management skills.
  • Proficiency with credentialing and payer enrollment software and systems.
Responsibilities
  • Manage the credentialing process for all healthcare providers, ensuring timely completion and ongoing compliance with payer requirements.
  • Oversee payer enrollment activities for new and existing providers, ensuring that all providers are credentialed and enrolled in a timely manner.
  • Monitor credentialing and payer enrollment timelines and proactively address delays or issues.
  • Maintain up-to-date records of provider credentials and payer contracts in compliance with regulatory and payer standards.
  • Collaborate with the RCM and finance teams to resolve any credentialing or enrollment issues that may impact reimbursement.
  • Develop and maintain relationships with payers to ensure efficient payer enrollment and re-credentialing processes.
  • Ensure compliance with state, federal, and payer-specific requirements for credentialing and enrollment.
  • Provide regular reports on the status of provider credentialing and payer enrollments to leadership.

Affect Therapeutics provides a digital platform for addiction recovery, utilizing a science-based method known as contingency management. This approach combines financial incentives, therapy, and medication to encourage healthy behaviors and support individuals in overcoming their addictions. Clients can access treatment through secure video conferences, allowing for privacy and convenience without the need to visit a physical clinic. In addition to addiction treatment, Affect Therapeutics offers support in areas that affect recovery, such as job searching and financial management, recognizing that sobriety is linked to overall life improvement. The company operates on a subscription or fee-for-service model, making it distinct from traditional rehab centers by offering a fully digital and holistic approach to recovery.

Company Stage

Series A

Total Funding

$22.4M

Headquarters

Remote, Oregon

Founded

2020

Growth & Insights
Headcount

6 month growth

5%

1 year growth

34%

2 year growth

162%
Simplify Jobs

Simplify's Take

What believers are saying

  • Raised $16M in Series A funding for national and program expansion.
  • Holds outpatient treatment licenses in 20 states, aiming for majority U.S. coverage by 2023.
  • Increased telehealth adoption boosts demand for digital addiction recovery solutions.

What critics are saying

  • Increased competition from other digital health startups may dilute market share.
  • Reliance on financial incentives may face ethical scrutiny or regulatory challenges.
  • Rapid expansion plans may strain resources and affect service quality.

What makes Affect Therapeutics unique

  • Affect Therapeutics offers a fully digital addiction treatment via a mobile app.
  • The company uses contingency management, rewarding healthy behaviors with financial incentives.
  • Affect provides a holistic approach, addressing addiction and broader life circumstances.

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