Credentialing Manager

Bierman Autism Centers•Indianapolis, IN

1d•$60,000 - $70,000

About The Position

As a member of the Credentialing Team, you guide and oversee the provider onboarding and re-credentialing processes that are vital to expanding and maintaining access to care. You understand that credentialing is more than checking boxes — it is about ensuring families can begin services on time, providers can deliver care without interruption, and the organization remains in full compliance with payer and regulatory requirements. Your leadership ensures that details are managed consistently, deadlines are met, and team members are supported in their day-to-day work. By building efficient systems, resolving escalated issues, and maintaining strong payer relationships, you safeguard the organization’s ability to grow its provider network, welcome new families, and continue delivering high-quality care.

Requirements

Must have manual dexterity to perform specific computer and electronic device functions
Must have visual acuity to read and comprehend written communication though computer, electronic devices, and paper means.
Must be able to maintain prolonged periods of working on a computer while sitting at a desk and attending virtual meetings

Nice To Haves

Bachelor’s degree in healthcare administration, business, or related field preferred.
Minimum 3–5 years of experience in provider credentialing, payer enrollment, or healthcare compliance.
Strong knowledge of payer credentialing requirements, CAQH, NPI, Medicaid/Medicare enrollment, and regulatory compliance standards.
Proven ability to manage credentialing lifecycles with accuracy and efficiency.
Demonstrated success achieving high clean submission rates and fast turnaround times.
Strong organizational skills with the ability to manage multiple applications, rosters, and deadlines simultaneously.
Excellent communication and relationship-building skills for interactions with payers, providers, and internal teams.
Proficiency with credentialing databases, RCM/EHR systems, and Microsoft Office Suite.
High attention to detail and commitment to accuracy and compliance.
Strong problem-solving skills and persistence in resolving escalated issues.

Responsibilities

Lead and oversee all credentialing and re-credentialing processes to ensure providers are fully authorized to deliver care within established timelines.
Develop, implement, and maintain credentialing policies, procedures, and workflows that ensure accuracy, consistency, and compliance.
Prepare, review, and submit credentialing applications, ensuring =95% are accepted on first submission.
Communicate in an effective, timely, and professional manner with clinicians/providers, including both new hires and current team members. Be able to answer questions and support clinicians in submitting all necessary credentialing paperwork.
Monitor credentialing turnaround times, achieving =30 days for re-credentialing and =90 days for new providers.
Manage payer rosters and internal systems to maintain =98% provider directory accuracy.
Manage provider systems and data including NPI numbers, CAQH profiles, Medicaid portals, and other supportive tasks to ensure credentialing stays accurate and current.
Serve as the escalation point for complex or delayed credentialing issues, engaging directly with payers and regulatory agencies as needed.
Collaborate with Contracting, Billing, and AR teams to ensure credentialing data is correctly implemented and prevents claim denials.
Provide regular reporting to leadership on credentialing performance metrics, compliance status, and provider network growth.
Support and mentor team members (including a Credentialing Coordinator direct report if applicable), fostering accuracy, accountability, and professional development.
Maintain detailed and organized documentation of applications, payer communications, and compliance activities for audit readiness.
Identify and implement process improvements to streamline credentialing workflows and strengthen compliance.
Use all internal systems proficiently and build new systems as needed.
Build and maintain relationships with payer credentialing departments and be able to contact payers directly to resolve issues.
Ensure adherence to HIPAA, payer, and regulatory requirements at all times.