Mindoula

We identify, engage, and serve populations with behavioral health, medical, and social challenges across the continuum.

Credentialing Manager

ManagerManagerFull TimeRemoteTeam 201-500Since 2015H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

27 days ago

Salary

$65K - $80K / year

Bachelor Degree3 yrs expEnglish

Job Description

• The Credentialing Manager leads the end to end credentialing, privileging, and payer enrollment function for the Managed Service Organization. • Ensure timely, compliant provider onboarding while maintaining high standards of operational accuracy, audit readiness, and service excellence. • Oversee full lifecycle credentialing, re-credentialing, privileging, and payer enrollment for all providers. • Manage complex, escalated, or high priority credentialing cases. • Support compliance and audit readiness practices, maintaining audit ready provider files and documentation standards. • Provide day to day leadership, coaching, and workload management for credentialing specialists. • Develop team capabilities through training and process documentation. • Monitor turnaround times, application status, and enrollment effective dates. • Partner with cross-functional teams for seamless provider onboarding and resolve credentialing related denials or reimbursement delays.

Job Requirements

  • Bachelor’s degree preferred; relevant experience may substitute
  • CPCS certification strongly preferred
  • Minimum three years of credentialing experience including payer enrollment and privileging
  • Prior supervisory or team lead experience required
  • Strong knowledge of NCQA, CMS, and payer credentialing standards
  • Proficiency with Google Suite, Excel or Sheets, credentialing databases, and workflow tools
  • Exceptional organizational skills and attention to detail
  • Ability to manage multiple deadlines in a high volume environment
  • Strong judgment, problem solving ability, and professional communication skills
  • Ability to lead with accountability while maintaining strong provider relationships.

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