Supervisor Credentialing

SCA Health•UNAVAILABLE, UNAVAILABLE

About The Position

The Facility Credentialing and Payer Enrollment Supervisor oversees credentialing and payer enrollment for healthcare providers and facilities. The role ensures providers are appropriately credentialed with insurance payers, regulatory requirements are met, and records are maintained according to company and payer guidelines. The supervisor works with internal and external stakeholders to streamline processes and improve operational efficiency. The work schedule is Monday through Friday, with hours anywhere between 8:00 a.m. and 5:30 p.m. EST or 7:00 a.m. and 4:30 p.m. CST.

Requirements

High school diploma or GED.
At least 3–5 years of experience in credentialing, payer enrollment, or healthcare operations.
At least 2 years of experience in a supervisory or managerial role.
Strong understanding of payer requirements, credentialing processes, and healthcare compliance regulations, including CAQH, Availity, and CMS guidelines.
Ability to manage a team and prioritize tasks in a fast-paced environment.
Strong organizational and time-management skills.

Nice To Haves

Bachelor's degree in healthcare administration, business, or a related field.

Responsibilities

Oversee credentialing and recredentialing for anesthesia providers and facilities according to payer, state, and accreditation standards.
Ensure required documentation, including applications, licensure verification, and malpractice insurance, is current in the credentialing database.
Work with the contracting department on new agreements and ensure required documents are provided to payers on time for contract execution.
Collaborate with Revenue Cycle, compliance, and contracting teams to align credentialing and enrollment with billing and reimbursement requirements.
Maintain payer relationships and escalate credentialing issues to payer leadership.
Monitor payer requirements, regulations, and industry trends to ensure compliance with federal, state, and payer regulations.
Review applications before they are sent to payers.
Lead, supervise, and train credentialing and payer enrollment staff.
Analyze trends and issues in credentialing and enrollment processes and develop improvement strategies.
Develop and maintain standard operating procedures for credentialing and payer enrollment workflows.
Identify process improvements and develop efficient solutions.