What are the responsibilities and job description for the Senior Manager of Credentialing position at Imagine Staffing Technology?

Job Description

Job Profile

Job Title : Senior Manager of Credentialing

Location : Buffalo, NY

Hire Type : Direct Hire

Pay Range : $90k - $100k

Work Model : Onsite

Recruiter Contact : Karissa Lubberts I klubberts@imaginestaffing.net I 716-256-1254

Nature & Scope : Positional Overview

Are you a detail-oriented leader with a passion for ensuring seamless provider credentialing? Our client is seeking a Senior Credentialing Manager to join their billing team in a direct hire role! In this key position, you’ll collaborate closely with the Medical Staff team and external vendors to ensure timely credentialing for new and existing providers—directly impacting revenue generation. You’ll oversee the preparation and submission of payer credentialing paperwork, ensuring accuracy and compliance for both initial applications and re-certifications. Your expertise in communication and follow-through will be critical in securing payer credentialing before provider start dates. If you’re ready to lead a high-impact process and thrive in a fast-paced healthcare environment, we’d love to hear from you!

Role & Responsibility :

Tasks That Will Lead To Your Success

Leadership Team Functions

Acts as staff resource and role model for ethical, professional conduct; Has the ability to provide guidance on processes within credentialing.
Monitors credentialing processes and identifies areas in need of improvement.
Participates in the hiring, onboarding, and ongoing training processes of credentialing specialists
Delegates duties and projects to appropriate staff, and monitors for accurate and prompt completion.
Stays apprised of all relevant regulations, standards, and directives from regulatory agencies and third- party payers.
Stays apprised of changing healthcare trends and leverages technology and automation to develop and deliver new products and services to customers.
Demonstrates knowledge of safety policies and procedures and actively maintains a safe and positive work environment.
Carries out other assignments or special projects as required.

Role Specific Functions

Works with other department managers and staff—including physicians, managed care, contracting, and other professional staff—to acquire necessary materials and information for provider certification and licensure to promote organization-wide compliance with credentialing policies and procedures.

Providers oversight of verification and payer credentialing of health care professions and credentials are in compliance with state and federal standards.

Oversees process and organization of all-payer credentialing and re-credentialing paperwork with participating insurance companies.

Maintains a database of practitioner’s training, education, licensing, and experience information

Key liaison with Medical Staff team, outside vendor, and IT.

Holds team accountable for maintaining and obtaining up-to-date provider documentation.

Assists in filling out and reviewing applications with practitioners and other applicable staff.

Performs ongoing provider database maintenance for accuracy and completeness.

Sets and monitors responsibilities of subordinate staff; strategically distributes tasks and workload appropriately.

Remains compliant with and knowledgeable of rules and regulations set forth by the Health Information Portability and Accountability Act (HIPAA), Joint Commission standards, the HCQIA, the National Committee for Quality Assurance (NCQA), the Centers for Medicare & Medicaid Services (CMS), as well as state regulations—and relays this information to the necessary parties to ensure ongoing compliance organization-wide.

Skills & Experience

Qualifications That Will Help You Thrive

Bachelor’s degree in healthcare-related field or 10 years of relevant work experience required.

Certification through National Association of Medical Staff Services (NAMSS) preferred

Exemplary problem-solving and conflict-resolution skills

Detail- oriented

Skilled in synthesizing a wealth of information

Exhibits excellent time management and prioritization abilities

Communicates effectively both one-on-one and in a group setting

Capable of following and providing detailed instructions both orally and through written communication

Experience with credentialing database management software preferred

Extensive experience working with Microsoft Office Suite (Word, Excel, PowerPoint, Outlook, Access, Project

Salary : $90,000 - $100,000

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