Credentialing AR Manager- (US Health Care)

The Credentialing Manager oversees day-to-day credentialing operations, ensuring team efficiency, compliance with regulatory standards, and timely processing of provider applications.

The role includes managing associates, training, quality control, and client coordination.

Experience Required: 7–10 years (including 3–4 years in a leadership role)

Location: Hyderabad

Shift: US Shift

Key Responsibilities:

• Supervise and guide a team of credentialing associates, ensuring adherence to SLA and quality benchmarks.

• Allocate workloads, track performance, and conduct regular quality audits.

• Act as a point of contact for internal stakeholders and clients for escalations and updates.

• Monitor credentialing and re-credentialing pipelines to ensure deadlines are met.

• Train new hires and provide refresher training for existing team members.

• Analyze process gaps and recommend continuous improvement measures.

• Prepare and share weekly/monthly reports with management and clients.

• Stay updated on payer-specific credentialing requirements and regulatory updates.

Qualifications:

• Bachelor’s degree require.

• Strong understanding of credentialing processes, CAQH, PECOS, NPPES, etc.

• Prior team management experience in an RCM/healthcare BPO setting.

• Excellent leadership, communication, and problem-solving skills.

• Experience working with US healthcare payers and credentialing portals.