Medicaid Credentialing & RCM Specialist

Finni Health; Northern (KY); Hybrid; USD 80,000 - 110,000; Full time

Job summary

Finni Health is seeking a Credentialing Manager to optimize revenue cycle operations and scale the payer network. You will guide enrollment submissions and oversee an offshore team, ensuring efficient processes and regulatory compliance across CMS, NCQA, and internal standards.

You must have Medicaid experience and 5+ years in credentialing or related roles, with strong analytical, collaboration, and communication skills.

Qualifications

• 5+ years of credentialing or related roles in healthcare tech or early-stage startups.
• Medicaid experience is required.
• Strong understanding of payer credentialing prerequisites and blockers.
• Demonstrated ability to manage enrollment submissions and payer relationships.

Responsibilities

• Payer Network Management: scale insurance contracts and unblock applications with payers; onboard and maintain relationships.
• Offshore Team Management: oversee enrollment submission team; ensure productivity and accurate updates in credentialing platform.
• Customer Triage: address payer enrollment questions for providers and staff.
• Compliance and Quality Assurance: ensure adherence to CMS, NCQA, and internal policies; maintain compliance across RCM functions.
• Operational Efficiency and Project Management: lead workflow improvements to maximize reimbursement and reduce denials; manage projects.
• Cross-Functional Collaboration: partner with product, provider success, compliance, HR, and finance to align RCM with business goals.
• Adaptability & evolving responsibilities as Finni Health grows.

Skills

RCM expertise

Cross-functional collaboration

Analytical problem-solving

Communication

Organizational skills

Adaptability

Tools

Google Suite

Slack

CRM software

EHR/RCM tools

Job description

Finni Health is seeking a Credentialing Manager to optimize revenue cycle operations and scale the payer network. You will guide enrollment submissions and oversee an offshore team, ensuring efficient processes and regulatory compliance across CMS, NCQA, and internal standards.

You must have Medicaid experience and 5+ years in credentialing or related roles, with strong analytical, collaboration, and communication skills.