Credentialing Manager

Job Summary

A company is looking for a Manager of Credentialing.

Key Responsibilities

• Oversees department's work queues and productivity reports for timely submission of credentialing documents
• Develops and implements standardized guidelines and provides leadership and training to credentialing staff
• Maintains compliance with Federal and State regulations while managing departmental budget and process improvements

Required Qualifications

• High School Diploma or GED required; Bachelor's degree preferred
• Minimum of 2 years of credentialing experience
• Proficiency in Microsoft Office, particularly Excel, Word, and Outlook
• Knowledge of Medicare, Medicaid & third-party provider enrollment processes
• Experience with CAQH, PECOS & NPPES and knowledge of NCQA & JACHO guidelines