Credentialing Ops Lead: KPI & Compliance

MYRIAD SYSTEMS INC; City of White Plains (NY); On-site; USD 55,000 - 65,000; Full time

Job summary

MYRIAD SYSTEMS INC in White Plains, NY seeks a Sr. Credentialing Lead to oversee end-to-end credentialing operations, drive KPI attainment, and enforce standardized workflows across clients and payers.

This leadership role focuses on timely submissions, accuracy, and regulatory compliance. You will manage a team, optimize enrollment processes (EFT, ERA, EDI), coordinate with billing and revenue cycle teams, and deliver clear client communications and weekly status updates.

Qualifications

• Minimum 4+ years in credentialing operations.
• 3+ years in leadership or management role.
• Experience managing multi client credentialing portfolios.
• Strong knowledge of CAQH, NPPES, PECOS, and payer enrollment processes.
• Understanding of multi state credentialing requirements.
• Excellent communication and interpersonal skills.

Responsibilities

• Own and drive all credentialing workflows across clients and payers
• Oversee full lifecycle from intake through approval
• Enforce standardized workflows across all specialists
• Identify bottlenecks and implement process improvements
• Ensure payer specific requirements are met on first submission
• Oversee completion of all EFT, ERA, and EDI enrollments
• Track enrollment status from submission through approval
• Ensure alignment with billing systems and clearinghouse requirements
• Troubleshoot enrollment issues and payer discrepancies
• Maintain accurate records of confirmations and effective dates
• Partner with billing and revenue cycle teams to prevent delays
• Implement tracking systems to eliminate revenue impact from enrollment gaps

Skills

Leadership

Communication

Attention to detail

Organizational skills

Education

Associates Degree required

Bachelor’s Degree in Healthcare Administration, Business Administration, or related field preferred

CPCS certification preferred

Tools

CAQH

NPPES

PECOS

Payer enrollment systems

Job description

MYRIAD SYSTEMS INC in White Plains, NY seeks a Sr. Credentialing Lead to oversee end-to-end credentialing operations, drive KPI attainment, and enforce standardized workflows across clients and payers.

This leadership role focuses on timely submissions, accuracy, and regulatory compliance. You will manage a team, optimize enrollment processes (EFT, ERA, EDI), coordinate with billing and revenue cycle teams, and deliver clear client communications and weekly status updates.