Healthcare Credentialing Team Lead: Data-Driven & Compliance

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

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.