Medical Credentialing Manager

AMS Solutions

3d•Remote

About The Position

The Medical Credentialing Manager leads AMS Solutions’ credentialing and payer enrollment team while managing an individual caseload. The role is accountable for the quality and turnaround of client enrollments, serves as the primary contact for credentialing clients, and partners with sales to scope and onboard new accounts. This is a full-time, fully remote position open to candidates in the United States, reporting to the Operations Manager.

Requirements

At least 5 years of provider credentialing and payer enrollment experience.
At least 2 years of experience leading or supervising a credentialing team.
Deep working knowledge of CAQH, PECOS, Medicaid enrollment, commercial payer contracting, and revalidation cycles.
Experience with multiple specialties and multi-state enrollment.
Strong understanding of how credentialing affects billing and revenue cycle.
Excellent written and verbal communication skills, including comfort leading client calls and handling sensitive information confidentially.
Highly organized, with strong follow-through and attention to detail.
Proficiency with credentialing software and Microsoft 365.
Must be authorized to work in the United States.

Nice To Haves

Familiarity with hospital privileging and state licensing.
CPCS or CPMSM certification.

Responsibilities

Lead the credentialing team’s day-to-day work by assigning and prioritizing cases, setting turnaround expectations, reviewing work for accuracy, and coaching team members.
Manage a personal caseload of initial enrollments, recredentialing, and revalidations with commercial payers, Medicare (PECOS), and Medicaid.
Maintain CAQH profiles and attestations, provider portal registrations, and provider files, including license, DEA, and malpractice expiration information.
Support provider licensing applications and hospital privileging as needed.
Serve as the primary contact for credentialing clients, provide weekly status updates, and resolve escalations.
Follow up with payers until participation is confirmed and keep enrollment tracking current and accurate.
Partner with sales to scope credentialing proposals, confirm payer lists, and onboard new clients.
Coordinate with the billing team to ensure new providers are linked under group contracts and claims can be submitted cleanly.
Identify process gaps and improve team workflows, templates, and tracking tools.