Credentialing Manager: AI-Driven Enrollment

fay

United States

On-site

USD 60,000 - 120,000

Full time

7 days ago

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Job summary

Fay is seeking a Credentialing Manager to lead enrollment and credentialing workflows for a network of dietitians. This hands-on role manages contractors and vendors, ensures accurate CAQH ProView and payer portal submissions, and drives issues to resolution in a fast-paced startup setting.

You will report to the Head of Provider Operations and collaborate with credentialing and RCM teams to avoid billing delays.

Qualifications

Hands-on credentialing and enrollment experience with CAQH ProView, payer portals, license verification, application submission and tracking.
Strong Excel/spreadsheet skills with formulas, filtering, pivot tables, and keeping large trackers clean and accurate.
An owner's mindset: you spot problems, dig into why something broke, and drive it to resolution on your own, including SOP improvements.
Strong attention to detail to prevent credentialing errors and ensure accuracy.

Responsibilities

Execute provider enrollment and credentialing applications across payers (CAQH ProView, primary source verification, payer portal submissions, and follow-up).
Track application status and turnaround times; flag delays or missing documentation before bottlenecks.
Maintain clean, accurate tracking in spreadsheets/dashboards (status logs, SLA trackers, denial/resubmission).
Troubleshoot issues (missing NPI data, license discrepancies, portal quirks) and drive to resolution.
Use AI tools to speed up repetitive or research-heavy work when applicable.
Partner with credentialing and RCM teams to ensure enrollment status doesn't block billing or go-live.