Credentialing Manager

Job highlights

• Minimum 6-8 years of hands-on experience in provider credentialing and enrollment
• Required Skills . Strong understanding of documents required for individual and group enrollments
• This is a permanent work-from-home role and requires strong attention to detail,good communication,and the ability to manage multiple applications independently. About the Role

About the Company

We are hiring experienced Credentialing Managers who can handle the entire process managing a team of Credentialing Specialists, along with enrolling healthcare providers with insurance companies. This is a permanent work-from-home role and requires strong attention to detail, good communication, and the ability to manage multiple applications independently.

About the Role

Manage end-to-end provider credentialing and insurance enrollment for individual and group providers.

Responsibilities

• Submit and track enrollment applications across all US states.
• Team Leadership: Guiding a team of credentialing specialists, tracking turnaround times (TAT), and solving complex insurance denial escalations.
• System Knowledge: Expert-level familiarity with PECOS, CAQH, and specific Revenue Cycle Management (RCM) tools.
• Attention to Detail: Tracking expiration dates for numerous documents simultaneously without error.
• File Letters of Interest (LOIs) and follow up with insurance payers via calls and emails.
• Work with private insurance, Medicare, Medicaid, Medicaid MCOs, and Medicare Advantage plans.
• Maintain and update provider profiles on portals like:
  • CAQH
  • PECOS
  • Availity
  • Navinet
  • NPPES
• Apply for and renew provider licenses such as:
  • Professional licenses
  • DEA
  • Controlled Substance licenses
  • Ensure provider information and documents are always accurate and up to date.
  • Regularly update clients on application status and ensure providers remain active with payers.
  • Work independently while staying highly engaged with the remote team.

Qualifications

• Minimum 6-8 years of hands-on experience in provider credentialing and enrollment.
• At least 2 years of experience as a Credentialing Manager / Team Lead

Required Skills

• Strong understanding of documents required for individual and group enrollments.
• Proven experience handling payer communication and follow-ups.
• Comfortable managing multiple applications with accuracy and deadlines.
• Excellent organization and time-management skills.
• Strong written and verbal communication skills for remote work.

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Disclaimer: This job posting has been aggregated from external source. Role details, content, and availability are subject to change. Applicants are advised to confirm the latest information directly on the company website before applying.