Posted 3mo ago

Credentialing Manager

@ River Valley Health
Morristown, Tennessee, United States
OnsiteFull Time
Responsibilities:Manage credentialing, Maintain records, Liaise insurers
Requirements Summary:2+ years payor/provider credentialing; bachelor's preferred; strong knowledge of payor requirements; excellent communication and organization; proficient in credentialing software and MS Office.
Technical Tools Mentioned:Credentialing software, Microsoft Office Suite
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Job Description

Credentialing Manager

Are you an organized, detail-oriented professional with experience in healthcare credentialing? We are seeking a Payor Credentialing Manager to join our growing organization. In this role, you will be responsible for overseeing and managing the external credentialing process for our healthcare providers with insurance payors, ensuring compliance with all regulations and requirements.

Key Responsibilities:

  • Manage the payor credentialing process for new and existing providers.
  • Maintain up-to-date records and documentation for all credentialed providers.
  • Liaise with insurance companies, providers, external, and internal teams to resolve issues and expedite credentialing.
  • Ensure compliance with federal, state, and payor-specific regulations.
  • Monitor credentialing deadlines and proactively address expiring credentials.

Qualifications:

  • Bachelor’s degree preferred; equivalent experience considered.
  • Minimum 2 years of experience in payor or provider credentialing.
  • Strong knowledge of insurance payor requirements and credentialing standards.
  • Excellent communication, organizational, and problem-solving skills.
  • Proficient in credentialing software and Microsoft Office Suite.

Equal Opportunity Employer. Job description subject to change.