Credentialing Manager

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

📋 Description

• Lead initiatives to expand Finni Health's network of insurance contracts and address stalled payer applications.

• Supervise the enrollment submission team, ensuring timely, consistent, and precise payer follow-up documented in the credentialing platform.

• Address inquiries from providers and support staff regarding updates and the status of payer enrollment.

• Ensure compliance with payer regulations, CMS billing, NCQA Guidelines, Delegated Credentialing, and internal policies.

• Spearhead RCM workflow optimization projects to enhance reimbursement and reduce denials.

• Collaborate with product, provider success, compliance, HR, finance, and various other teams.

• Assume evolving responsibilities and projects as Finni Health expands.

⛳️ Requirements

• Over 5 years of relevant experience in credentialing or similar roles.

• Background in healthcare credentialing or provider enrollment.

• Strong grasp of payer credentialing processes, including prerequisites, barriers, remediation, roster management, and demographic updates.

• Experience with Medicaid is essential.

• Profound understanding of the complete revenue cycle, encompassing billing, claims processing, collections, accounts receivable management, payer contracting, and compliance.

• Ability to analyze complex RCM data, detect trends and root causes, and develop data-driven solutions.

• Proficient in identifying inefficiencies and promoting RCM process enhancements.

• Outstanding written and verbal communication abilities.

• Exceptional organizational and time management skills; capable of juggling multiple priorities and projects.

• Familiarity with Google Suite, Slack, CRM/support software, and EHR/RCM management tools.

• Experience in EMR/EHR work queue management within RCM is advantageous.

• Capable of working both collaboratively and independently in a dynamic, fast-paced startup environment.

• Must possess authorization to work in the United States.

🏝️ Benefits

• Competitive salary and performance-based bonuses.

• Comprehensive health, dental, and vision insurance.

• Generous paid time off and flexible working arrangements.

• Professional development opportunities and continuous learning.

• A vibrant and inclusive company culture.