Credentialing Manager

Finni Health
United States
Workplace: RemoteFull timeUSD 70,000 - 85,000 annuallyFunction: Business OperationsExperience: 5+ yearsSkills: ["Proactive","Collaboration","Communication","Analytical thinking","Organizational skills"]

Own revenue cycle credentialing operations by managing payer network growth and unblocking stalled applications. Lead an offshore enrollment submission team to ensure timely, accurate credentialing updates in the credentialing platform. Triage payer enrollment questions for providers and support staff, enforce payer and compliance requirements (including CMS billing and NCQA/Delegated Credentialing), and drive workflow optimization projects to maximize reimbursement and minimize denials through cross-functional collaboration.

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Finni Health
Finni Health
1 day ago

Credentialing Manager

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Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI
Last checked: 15 hours agoStatus: Live
Reposted: similar role first listed 5 months ago

Job Summary

Own revenue cycle credentialing operations by managing payer network growth and unblocking stalled applications. Lead an offshore enrollment submission team to ensure timely, accurate credentialing updates in the credentialing platform. Triage payer enrollment questions for providers and support staff, enforce payer and compliance requirements (including CMS billing and NCQA/Delegated Credentialing), and drive workflow optimization projects to maximize reimbursement and minimize denials through cross-functional collaboration.
Location: United States
Workplace: Remote
Employment Type: Full time
Job Function: Business Operations
Seniority: Manager level

Key Responsibilities

  • •Manage payer network expansion by scaling insurance contracts and unblocking stalled applications while ensuring ongoing relationship management.
  • •Oversee the enrollment submission team to meet productivity expectations and ensure active payer follow-up is timely, consistent, accurate, and recorded in the credentialing platform.
  • •Triage provider and support staff questions related to payer enrollment updates, status, and general payer enrollment inquiries.
  • •Ensure strict compliance with payer regulations and industry standards (e.g., CMS billing, NCQA guidelines, Delegated Credentialing) and internal policies across RCM functions.
  • •Lead workflow optimization and project initiatives within RCM to improve efficiency, maximize reimbursement, and minimize denials while collaborating cross-functionally.

Pay and Benefits

Salary: USD 70,000 - 85,000 annually

Key Requirements

  • •5+ years of experience in credentialing or related roles, preferably in an early-stage startup, behavioral/mental health, or healthcare tech.
  • •Medicaid experience is required.
  • •Strong understanding of payer credentialing processes, including credentialing prerequisites, blockers/remediation, roster management, and demographic updates.
  • •Deep revenue cycle knowledge (billing, claims processing, collections, accounts receivable) and payer contracting/compliance (e.g., CMS billing).
  • •Ability to analyze complex RCM data, identify root causes and trends, and implement data-driven solutions and process improvements.
Experience:5+ yearsHealthcareHealthcare techRevenue cycle managementBehavioral health
Skills:ProactiveCollaborationCommunicationAnalytical thinkingOrganizational skills
Tech Stack:Google SuiteSlackCRM/support softwareEHRRCM management toolsEMRCredentialing platform

Company Brief

Finni Health
Finni Health is an MSO and platform that helps ABA providers start, run, and grow in‑network autism care practices by providing billing, credentialing, operations, staffing, and growth support.
Industry: HealthTech
Company Size: Large (251 to 1,000 employees)
Growth: Early Stage Startup
Funding: Series A
Headquarters: Las Cruces, United States
Founded: 2022
Glassdoor
Glassdoor: 3.9
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