Contracting & Credentialing Manager
Agility Billing Services•Melville, NY
•$85,000 - $115,000
About The Position
Agility Billing Services is a medical billing and revenue cycle management company supporting a growing portfolio of orthopedic, surgical, and specialty practice clients across the tri-state area. We’re building out a dedicated Contracting & Credentialing function, and we’re hiring a Contracting & Credentialing Manager to lead it. This role owns payer contracting and provider credentialing/enrollment across our client portfolio, builds standardized processes for delivering that work at scale, and plays a direct role in strengthening our service offering as we grow.
Requirements
- 5+ years of experience in healthcare payer contracting and/or provider credentialing
- Working knowledge of the NY/NJ/CT managed care landscape and No Surprises Act/IDR framework
- Hands-on experience with CAQH, PECOS/NPPES, and payer credentialing portals
- Strong contract review and negotiation skills
- Excellent organizational skills — comfortable managing multiple concurrent contracts and provider files
- Proficiency in Excel and practice management/credentialing software
Nice To Haves
- CPCS (Certified Provider Credentialing Specialist) or CPMSM certification
- CPC or similar coding/billing credential
- Experience with orthopedic or surgical specialty reimbursement structures
- Experience managing credentialing/contracting across multiple client accounts or practices
- Familiarity with DrChrono, ModMed, or similar practice management/EHR systems
Responsibilities
- Lead negotiation, renewal, and management of managed care and commercial payer contracts (BCBS, UnitedHealthcare, Aetna, Cigna, Medicare/Medicaid MCOs, No-Fault/Workers’ Comp payers) across NY, NJ, and CT
- Analyze fee schedules and contract terms to identify underpayment risk and negotiation opportunities
- Track in-network status, contract renewal/termination windows, and payer relationships across multiple client accounts
- Advise on No Surprises Act/IDR exposure tied to contracting gaps
- Stay current on state-specific managed care regulations (NY DFS, NJ C.32/Maximus, CT DOI)
- Own end-to-end credentialing and re-credentialing for providers across client accounts — CAQH, NPI/PECOS, state licensure, malpractice/COI documentation
- Build standardized workflows and tracking tools to support consistent turnaround and accuracy across accounts
- Coordinate timely enrollment for newly hired providers to minimize revenue delays
- Serve as primary liaison to payer provider relations/network management teams
- Help define and refine this service line as part of the company’s broader growth strategy
- Build onboarding processes for bringing new client accounts’ contracts and credentials into our systems efficiently
- As the team grows, help hire, train, and manage credentialing/contracting staff
- Report on contract performance, in-network status, and credentialing turnaround metrics
Benefits
- Medical, dental, and vision insurance
- 401(k) with employer contribution
- PTO + paid holidays
- Professional certification/continuing education support
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
No Education Listed
