Contracting & Credentialing Manager

Agility Billing Services, LLC

Melville (NY)

On-site

USD 85,000 - 115,000

Full time

2 days ago
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Job summary

Agility Billing Services, LLC is expanding a dedicated Contracting & Credentialing function and seeking a Contracting & Credentialing Manager to lead it. You will own payer contracting and provider enrollment across our client portfolio and establish scalable, standardized workflows.

Responsibilities include negotiating contracts with major payers across NY, NJ, and CT, guiding credentialing and enrollment, and helping grow the service line through process improvement and staff development.

Qualifications

  • 5+ years of experience in healthcare payer contracting and/or provider credentialing.
  • Experience with NY/NJ/CT managed care and No Surprises Act/IDR framework.
  • Hands-on use of CAQH, PECOS/NPPES, and credentialing portals.
  • Strong contract review and negotiation abilities.
  • Excellent organizational skills and multitasking across multiple contracts.

Responsibilities

  • Lead negotiation, renewal, and management of payer contracts across NY, NJ, and CT.
  • Analyze fee schedules to identify underpayment risk and opportunities.
  • Track in-network status and contract renewal/termination windows across client accounts.
  • Advise on No Surprises Act/IDR exposure tied to contracting gaps.
  • Stay current on state 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, licensure).
  • Build standardized workflows to support 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 growth strategy.
  • Build onboarding processes for bringing new client accounts’ contracts and credentials into our systems.
  • As the team grows, help hire, train, and manage credentialing/contracting staff.
  • Report on contract performance, in-network status, and credentialing turnaround metrics.

Skills

Negotiation skills
Organizational skills
Excel proficiency

Education

CPCS (Certified Provider Credentialing Specialist) or CPMSM certification
CPC or similar coding/billing credential

Tools

CAQH
PECOS/NPPES

Job description

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.

Key Responsibilities
Payer Contracting
  • 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)
Credentialing & Provider Enrollment
  • 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
Department Growth
  • 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
Qualifications
Required
  • 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
Preferred
  • 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
Salary and benefits
  • Salary range: $85,000–$115,000, based on experience
  • Medical, dental, and vision insurance
  • 401(k) with employer contribution
  • Professional certification/continuing education support
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