Full-time Payer Credentialing Manager - Remote (US)

Theoria Medical
Michigan
Workplace: RemoteFull timeFunction: Quality & Regulatory (Non-Software)Experience: 3+ yearsEducation: bachelorsSkills: ["Organizational skills","Attention to detail","Communication","Problem-solving"]

Lead payer credentialing and re-credentialing for healthcare providers, ensuring compliance with accreditation standards, state/federal regulations, and organizational policies. Oversee payer enrollments and manage the payer credentialing team, while maintaining accurate databases and electronic records for audit readiness. Serve as a liaison across medical staff, payers, licensure boards, and regulatory agencies, and run regular audits to identify gaps and drive continuous improvement in provider onboarding.

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FursaFursa
Theoria Medical
Theoria Medical
1 month ago

Full-time Payer Credentialing Manager - Remote (US)

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Source: Company careers pageValidated by: Fursa AI
Last checked: 7 hours agoStatus: Live

Job Summary

Lead payer credentialing and re-credentialing for healthcare providers, ensuring compliance with accreditation standards, state/federal regulations, and organizational policies. Oversee payer enrollments and manage the payer credentialing team, while maintaining accurate databases and electronic records for audit readiness. Serve as a liaison across medical staff, payers, licensure boards, and regulatory agencies, and run regular audits to identify gaps and drive continuous improvement in provider onboarding.
Location: Michigan
Workplace: Remote
Employment Type: Full time
Job Function: Quality & Regulatory (Non-Software)
Seniority: Manager level

Key Responsibilities

  • •Oversee initial payer application processing for health professionals while ensuring compliance with national accreditation standards and state/federal regulations.
  • •Maintain and manage payer credentialing databases and electronic records with accuracy, confidentiality, and audit readiness.
  • •Serve as a liaison with medical staff leadership, payers, licensure boards, and regulatory agencies to resolve credentialing issues.
  • •Supervise payer credentialing staff by coordinating workloads, providing training, monitoring performance, and ensuring quality outcomes.
  • •Conduct regular audits of payer credentialing processes to identify gaps, implement corrective actions, and drive continuous improvement.

Pay and Benefits

Perks:401kHealth InsuranceDentalVisionPaid LeavePaid HolidaysLife InsuranceRemote Work

Key Requirements

  • •Bachelor’s degree in healthcare administration, business, or related field.
  • •Minimum 3 years of payer credentialing or healthcare administration experience.
  • •1–3 years of supervisory or managerial experience.
  • •Demonstrated experience with payer enrollment processes.
  • •Hands-on experience with payer credentialing systems such as CAQH and Medallion.
Experience:3+ yearsHealthcare
Education:Bachelor's
Skills:Organizational skillsAttention to detailCommunicationProblem-solving
Languages:English
Tech Stack:CAQHMedallionDatabasesMicrosoft OfficeExcelAccessWordElectronic records

Company Brief

Theoria Medical
Designs and develops medical devices and digital diagnostic tools aimed at improving early detection and monitoring of neurological and sensory disorders, combining novel sensors with data analytics to support clinical decision-making and patient outcomes.
Industry: Medical Devices
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