Provider Credential & Policy Leader

Ohio BWC (official); Columbus (OH); On-site; USD 84,000 - 120,000; Full time

Job summary

BWC in Columbus, Ohio is seeking a Credential Review Manager to lead the Credential Review department’s day‑to‑day operations. You will supervise staff, collaborate with provider enrollment, and oversee disciplinary actions and related processes.

Ideal candidates have CPT/ICD coding experience, health‑care policy development, and strong writing skills for policy and procedure documentation. This is an on‑site role with a 40‑hour week and a salary range of $40.40–$57.67 per hour.

Qualifications

• CPT hospital coding or ICD coding experience; 12 months writing medical policies & procedures for medical provider or insurance company.
• Undergraduate or graduate program requirements as noted above; 12 months exp in healthcare field.

Responsibilities

• Manages and leads Credential Review department day-to-day operations
• Supervises staff and collaborates with provider enrollment and internal areas
• Leads provider network disciplinary actions and related processes
• Serves as lead expert in provider non-compliance processing/determinations
• Responsible for credential review research and policy/rule input
• Guides and designs department strategic direction for efficiency

Skills

Leadership and Management

Education

Undergraduate coursework in pre-medicine / allied medical field

Graduate program in health care administration

Equivalent Minimum Class Qualifications for Employment

Tools

PEACH provider database

BWC claims system

SharePoint

OhioBWC.com

Job description

BWC in Columbus, Ohio is seeking a Credential Review Manager to lead the Credential Review department’s day‑to‑day operations. You will supervise staff, collaborate with provider enrollment, and oversee disciplinary actions and related processes.

Ideal candidates have CPT/ICD coding experience, health‑care policy development, and strong writing skills for policy and procedure documentation. This is an on‑site role with a 40‑hour week and a salary range of $40.40–$57.67 per hour.