Full-time Payer Credentialing Manager - Remote (US)
About The Position
Theoria Medical is seeking a Payer Credentialing Manager to lead payer credentialing and re-credentialing processes for healthcare providers. This role ensures compliance with accreditation standards, regulatory requirements, and organizational policies. Responsibilities include overseeing payer enrollments, managing the credentialing team, maintaining data accuracy, and streamlining provider onboarding to reduce risk and support patient safety. Theoria Medical is a comprehensive medical group and technology company serving patients across the care continuum, with an emphasis on post-acute care and primary care. They offer multispecialty physician services, telemedicine, and remote patient monitoring.
Requirements
- Bachelor’s degree in healthcare administration, business, or related field.
- Minimum of 3 years in payer credentialing or healthcare administration.
- 1–3 years in a supervisory or managerial role.
- Demonstrated experience with payer enrollment processes.
- Hands-on experience with payer credentialing systems (e.g., CAQH, Medallion).
- Strong knowledge of databases and Microsoft Office applications (Excel, Access, Word).
- Strong organizational skills, attention to detail, communication, problem –solving, and knowledge of regulatory guidelines.
Responsibilities
- Oversee the processing of initial payer applications for health professionals, ensuring compliance with national accreditation standards and state/federal regulations.
- Maintain and manage payer credentialing databases and electronic records, ensuring accuracy, confidentiality, and audit readiness.
- Liaison with medical staff leadership, payers, licensure boards, and regulatory agencies to resolve credentialing issues promptly.
- 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.
Benefits
- Competitive salary
- 401(k) with employer match
- Health, dental, and vision insurance
- PTO + paid holidays
- Life insurance coverage
- Remote flexibility with a national legal scope
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What This Job Offers
Job Type
Full-time
Career Level
Manager
