Remote Payer Credentialing Manager

Theoria-Medical; Novi (MI); Remote; USD 85,000 - 120,000; Full time

Benefits offered by this job

401(k) with employer match

Health, dental, and vision insurance

PTO + paid holidays

Life insurance coverage

Remote flexibility with a national 0

Job summary

Theoria Medical is seeking a Payer Credentialing Manager to lead payer credentialing and re-credentialing for healthcare providers, ensuring compliance with accreditation standards and regulatory requirements. You will oversee enrollments, manage the credentialing team, and maintain accurate data to support safe patient care.

This remote role requires establishing efficient onboarding, maintaining audit readiness, and collaborating with medical staff leadership and payers to resolve issues

Qualifications

• Bachelor’s degree in a healthcare or related field is required.
• Minimum 3 years in payer credentialing or healthcare administration.
• 1–3 years in a supervisory or managerial role.
• Experience with payer enrollment processes and regulatory standards.

Responsibilities

• Oversee initial payer applications and ensure regulatory compliance.
• Maintain payer credentialing databases, ensuring accuracy and audit readiness.
• Coordinate with leadership, payers, licensure boards, and regulators to resolve issues.
• Direct credentialing staff, manage workloads, and provide ongoing training.
• Audit credentialing processes to identify gaps and drive improvements.

Skills

Payer credentialing

Regulatory compliance

Team leadership

Process improvement

Education

Bachelor's degree in healthcare administration, business, or related field

Tools

CAQH

Medallion

Excel

Access

Word

Job description

Theoria Medical is seeking a Payer Credentialing Manager to lead payer credentialing and re-credentialing for healthcare providers, ensuring compliance with accreditation standards and regulatory requirements. You will oversee enrollments, manage the credentialing team, and maintain accurate data to support safe patient care.

This remote role requires establishing efficient onboarding, maintaining audit readiness, and collaborating with medical staff leadership and payers to resolve issues