Payer Credentialing Manager
Theoria Medical
full-time
Posted on:
Location Type: Remote
Location: Remote • Missouri • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
About the role
- Oversee the processing of initial payer applications for health professionals, ensuring compliance with national accreditation standards and state/federal regulations.
- Maintain and manage payer credentialing databases and electronic records, ensuring accuracy, confidentiality, and audit readiness.
- Liaison with medical staff leadership, payers, licensure boards, and regulatory agencies to resolve credentialing issues promptly.
- Supervise payer credentialing staff by coordinating workloads, providing training, monitoring performance, and ensuring quality outcomes.
- Conduct regular audits of payer credentialing processes to identify gaps, implement corrective actions, and drive continuous improvement.
Requirements
- Bachelor’s degree in healthcare administration, business, or related field.
- Minimum of 3 years in payer credentialing or healthcare administration.
- 1–3 years in a supervisory or managerial role.
- Demonstrated experience with payer enrollment processes.
- Hands-on experience with payer credentialing systems (e.g., CAQH, Medallion).
- Strong knowledge of databases and Microsoft Office applications (Excel, Access, Word).
- Strong organizational skills, attention to detail, communication, problem –solving, and knowledge of regulatory guidelines.
Benefits
- Competitive salary
- 401(k) with employer match
- Health, dental, and vision insurance
- PTO + paid holidays
- Life insurance coverage
- Remote flexibility with a national legal scope
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
payer credentialingpayer enrollment processesdatabase managementMicrosoft ExcelMicrosoft AccessMicrosoft Wordauditingcorrective actionscontinuous improvement
Soft skills
organizational skillsattention to detailcommunicationproblem-solvingleadershiptrainingperformance monitoring