About Fabric Health

About the Role

What You'll Do

• Managing the complete provider enrollment and re-credentialing process with all relevant payers, including Medicare and Medicaid, and maintaining up-to-date CAQH profiles and TIN information.
• Overseeing the claims queue, analyzing denied claims and underpayments, and resolving issues in a timely manner.
• Maintaining meticulous accuracy of provider data — including NPIs, tax IDs, professional licenses, and addresses — across internal and payer-specific databases.
• Ensuring all MCO compliance documentation and provider data meet regulatory standards set by bodies such as NCQA and URAC.
• Serving as the primary point of contact with healthcare payers on network participation status, enrollment, and reimbursement inquiries.
• Identifying and reporting on trends in claim denials and outstanding A/R balances to support ongoing improvements in revenue cycle efficiency.

Why You Might Be a Good Fit

• You take pride in keeping data clean and processes airtight — small errors in this work have real downstream consequences and you understand that.
• You are comfortable navigating payer portals and credentialing systems and are not intimidated by the administrative complexity of managed care.
• You are a clear, confident communicator who can work effectively with both internal teams and external payer contacts to resolve issues quickly.
• You enjoy having ownership over a defined set of processes and finding ways to make them more efficient over time.

This Might Not Be The Right Fit If...

• You prefer variety and ambiguity over structured, process-driven work — this role requires consistency, precision, and attention to detail every day.
• You are not comfortable working across multiple payer portals and databases simultaneously or managing competing deadlines.
• You are looking for a primarily strategic or client-facing role — the core of this work is operational and detail-oriented.

Your Qualifications

• 1–3 years of experience in provider credentialing, enrollment, or managed care, preferably within a hospital or insurance setting.
• Demonstrated proficiency with payer portals such as Availity, PECOS, and eMedNY, and experience with credentialing software.
• Solid understanding of medical billing, coding, and claims adjudication processes.
• Strong analytical and critical thinking skills, with the ability to resolve complex enrollment issues under time pressure.
• Excellent written and verbal communication skills.
• High school diploma or GED required; Bachelor's degree preferred.
• Preferred certifications: CPCS, CPMSM, CPB, CBCS, and/or CMRS.
• Prior experience with virtual care platforms is a plus.

The national pay range for this role is $22.00 – $35.00 per hour. Actual compensation will be determined by factors such as the candidate's geographic market, experience, skills, and qualifications. If your compensation requirement is greater than our posted range, please still consider applying; a determination can be made based on unique qualifications. Expected compensation ranges for this role may change over time.

At Fabric, we believe that a diverse workforce is essential to our success. We are an equal opportunity employer and are committed to creating an inclusive environment for all employees. We do not discriminate on the basis of race, color, religion, sex, national origin, age, disability, veteran status, or any other legally protected characteristic. We actively encourage individuals from all backgrounds to apply.

Recruitment Fraud Alert: Protect Yourself

• Verify the Domain: Official recruitment emails will only come from addresses ending in @fabrichealth.com or @gem.com. No other domain names are legitimate.
• Official Interview Tools: We use Gem for our recruitment process and Google Meet for all video interviews. Google Meet is always the platform used for your first interview; you will never be sent a Zoom link to set up or conduct an initial interview. All interviews are conducted via video unless specifically stated by our team as an audio call. We never conduct interviews via chat, social media, Skype, or WhatsApp.
• Zoom Usage: Zoom is utilized only for specific meetings set directly by our team for purposes outside of the standard interview process (e.g., coordination or onboarding discussions). It is never the first link you will receive from us.
• Authorized Contact & Texting: Fabric will only contact you if you have submitted an application or if you are connected to a current employee who shared your information with us. We will only send text messages if you have provided explicit authorization and consent, either through your application or while communicating directly with our team. If you have not explicitly authorized us to reach out, treat any SMS or unsolicited outreach as fraudulent and do not respond.
• Sensitive Data: We will never ask you for sensitive personal or financial documents (ID, banking info, SSN) during the application, interview, or candidacy stages. All sensitive data is handled through secure internal systems post-offer.
• Verify the Team: You can reference LinkedIn to verify members of our recruiting team; however, please remain vigilant as scammers may create fraudulent profiles. Always cross-reference the sender's email domain with our official @fabrichealth.com address.