Credentialing Team Manager | Remote | USA

Sutherland Global; Clifton, Northern (NJ, KY); Hybrid; USD 75,000 - 110,000; Full time

Job summary

Sutherland Healthcare Solutions is seeking a Credentialing Supervisor to support our growing healthcare program. The role focuses on maintaining credentialing quality, ensuring regulatory adherence, and driving continuous improvements across processes.

You will lead a team of credentialing specialists, communicate with providers and payers, and develop data-driven strategies to meet timelines and standards. A CPC/COC/CCS/CCS-P certification and 6–7 years of related experience are preferred.

Qualifications

• Graduate/post-graduate with CPC/COC/CCS/CCS-P Certification by AAPC/AHIMA.
• Minimum 6-7 years with hands-on medical coding & credentialing.
• At least 2 years in a leadership role managing a team of credentialing specialists.
• Be able to work in a fast-paced environment.
• Have good working knowledge in MS Office applications: Word, Excel, PPT.
• Be able to interpret data, identify trends, and make suggestions for improvements.

Responsibilities

• Keep Management Updated: Relay vital information in the form of timely and accurate credentialing reports and compliance status updates.
• Impact the Bottom Line: Develop effective credentialing strategies based on accurate data analysis, regulatory requirements, and operational observations.
• Define Our Reputation: Oversee and manage credentialing quality and compliance standards to guarantee provider satisfaction and regulatory adherence; provide coaching and feedback to credentialing staff.
• Strengthen Relationships: Establish and maintain communication with providers, payers, and internal stakeholders; understand credentialing needs, resolve verification issues, and meet compliance expectations.
• Take the Lead: Monitor credentialing workflows and application queues as per defined timelines and targets; report delays or gaps; perform root cause analysis and implement corrective actions; drive turnaround time improvements; meet regulatory and payer requirements; support staff development.

Skills

Analytical skills

Verbal & written communication

Team-player

Fast-paced environment adaptability

MS Office (Word, Excel, PPT)

Education

CPC/COC/CCS/CCS-P Certification by AAPC/AHIMA

Tools

MS Office

Job description

Company Description:

About Sutherland

Artificial Intelligence. Automation. Cloud engineering. Advanced analytics. For business leaders, these are key factors of success. For us, they’re our core expertise.
We work with iconic brands worldwide. We bring them a unique value proposition through market-leading technology and business process excellence.

We’ve created over 200 unique inventions under several patents across AI and other critical technologies. Leveraging our advanced products and platforms, we drive digital transformation, optimize critical business operations, reinvent experiences, and pioneer new solutions, all provided through a seamless “as a service” model.

For each company, we provide new keys for their businesses, the people they work with, and the customers they serve. We tailor proven and rapid formulas, to fit their unique DNA. We bring together human expertise and artificial intelligence to develop digital chemistry. This unlocks new possibilities, transformative outcomes and enduring relationships.

Sutherland
Unlocking digital performance. Delivering measurable results.

Job Description:

Sutherland Healthcare Solutions is seeking a talented Credentialing Supervisors to support one of our growing Heathcare programs!

As a Credentialing Supervisor, you'll role get to:

Keep Management Updated: Relay vital information in the form of timely and accurate credentialing reports and compliance status updates.

Impact the Bottom Line: Develop effective credentialing strategies based on accurate data analysis, regulatory requirements, and operational observations.

Define Our Reputation: Oversee and manage credentialing quality and compliance standards to guarantee provider satisfaction and regulatory adherence; provide coaching and feedback to credentialing staff.

Strengthen Relationships: Establish and maintain communication with providers, payers, and internal stakeholders; understand credentialing needs, resolve verification issues, and meet compliance expectations.

Take the Lead: Monitor credentialing workflows and application queues as per defined timelines and targets; report out any delays or compliance gaps and take necessary action; perform root cause analysis on credentialing defects and implement corrective actions; drive credentialing turnaround time improvement initiatives; focus on meeting regulatory and payer requirements; meet credential maintenance and renewal goals set by the organization; be self-motivated to involve in staff development and continuous process improvement.

Qualifications:

Our most successful candidates will have:

• Graduate/post-graduate with CPC/COC/CCS/CCS-P Certification by AAPC/AHIMA
• Minimum 6-7 years with hands-on medical coding & credentialing
• At least 2 years in a leadership role managing a team of credentialing specialists
• Be able to work in a fast-paced environment
• Have good working knowledge in MS Office applications: Word, excel, & PPT
• Be able to adjust quickly and smoothly to changing priorities and conditions
• Have ability to interpret data, identify trends, and make suggestions for improvements
• Have strong analytical skills; be able to interpret data, identify trends, and make suggestions for improvements
• Be pro-active in developing trust and professional rapport with employees and team members; work as a team-player
• Have strong verbal and written communication skills; be able to communicate in a clear, constructive, and professional manner

Additional Information:

All your information will be kept confidential according to EEO guidelines.

EEOC and Veteran Documentation During employment, employees are treated without regard to race, color, religion, sex, national origin, age, marital or veteran status, medical condition or handicap, or any other legally protected status.
At times, government agencies require periodic reports from employers on the sex, ethnicity, handicap, veteran and other protected status of employees. The purpose of this Administrative EEO Record is for statistical analysis only and is used to comply with government record keeping, reporting, and other legal requirements. Periodic reports are made to the government on the following information. The completion of the Administrative EEO record is optional. If you choose to volunteer the requested information, please note that all
Administrative EEO Records are kept in a Confidential File and are not part of your Application for Employment or Personnel file.
Please note: YOUR COOPERATION IS VOLUNTARY. INCLUSION OR EXCLUSION OF ANY DATA WILL NOT AFFECT ANY EMPLOYMENT DECISION.