Credentialing Account Manager

This is a fully remote position, open to applicants in United States.

📋 Description

• Act as the primary point of contact for designated clients, proactively addressing their inquiries and concerns.

• Facilitate regular meetings with clients to review provider enrollment and credentialing data, tackle challenges, and align on objectives.

• Track and assess key performance indicators (KPIs) such as retention/turnover rates, credentialing turnaround times, Network Adequacy, and Net Promoter Score, among others.

• Supervise all activities related to provider enrollment, credentialing, and re-credentialing to ensure precision, timeliness, and compliance with payer requirements.

• Ensure effective tracking, reporting, and documentation of enrollment statuses, payer communications, and provider data across various systems.

• Serve as the main point of contact for complex issues related to providers, payers, or claims.

• Identify and execute process enhancements to optimize workflows, reduce cycle times, and enhance the provider experience.

• Standardize standard operating procedures (SOPs), reporting frameworks, and quality controls throughout the Provider Relations department.

• Examine trends, bottlenecks, and performance metrics to support decision-making and ongoing improvement initiatives.

• Act as a vital liaison with internal teams, including Revenue Cycle, Operations, Compliance, and Clinical Leadership.

• Provide updates and reports at the executive level to leadership regarding provider enrollment status, associated risks, and capacity planning.

• Ensure professional and clear communication with providers and external partners.

⛳️ Requirements

• Minimum of 5 years of experience in provider relations, credentialing, enrollment, or healthcare operations.

• At least 2 years of people management experience, which includes overseeing Team Leads or supervisors.

• A minimum of 2 years of account management or customer success experience, acting as the primary contact for clients.

• Strong grasp of medical billing, payer enrollment, claims resolution, and healthcare workflows.

• Demonstrated capability to lead teams, instill accountability, and apply scalable processes.

• Bachelor’s degree is required; a degree in healthcare administration, business, or process improvement is preferred.

• Outstanding organizational, analytical, and reporting abilities.

• Excellent communication skills with the capacity to influence at various levels and functions.

• Proficiency in Microsoft Office Suite and credentialing/enrollment databases.

• Ability to succeed in a fast-paced, high-growth environment with changing priorities.

• Detail-oriented with strong problem-solving and decision-making skills.

🏝️ Benefits

• Health insurance

• Dental insurance

• Vision insurance

• 401(k)

• Paid time off

• Bonus programs