Credentialing Manager at Bierman Autism Centers

Indianapolis, Indiana, United States -

Full Time

Start Date

Immediate

Expiry Date

09 Jul, 26

Salary

70000.0

Posted On

10 Apr, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Credentialing, Payer Enrollment, Healthcare Compliance, Provider Network Management, CAQH, NPI, Medicaid, Medicare, RCM Systems, EHR Systems, Data Management, Process Improvement, Reporting, Leadership, Relationship Building, Audit Readiness

Industry

Mental Health Care

Description

Description As a member of the Credentialing Team, you guide and oversee the provider onboarding and re-credentialing processes that are vital to expanding and maintaining access to care. You understand that credentialing is more than checking boxes — it is about ensuring families can begin services on time, providers can deliver care without interruption, and the organization remains in full compliance with payer and regulatory requirements. Your leadership ensures that details are managed consistently, deadlines are met, and team members are supported in their day-to-day work. By building efficient systems, resolving escalated issues, and maintaining strong payer relationships, you safeguard the organization’s ability to grow its provider network, welcome new families, and continue delivering high-quality care. Key Responsibilities: Lead and oversee all credentialing and re-credentialing processes to ensure providers are fully authorized to deliver care within established timelines. Develop, implement, and maintain credentialing policies, procedures, and workflows that ensure accuracy, consistency, and compliance. Prepare, review, and submit credentialing applications, ensuring =95% are accepted on first submission. Communicate in an effective, timely, and professional manner with clinicians/providers, including both new hires and current team members. Be able to answer questions and support clinicians in submitting all necessary credentialing paperwork. Monitor credentialing turnaround times, achieving =30 days for re-credentialing and =90 days for new providers. Manage payer rosters and internal systems to maintain =98% provider directory accuracy. Manage provider systems and data including NPI numbers, CAQH profiles, Medicaid portals, and other supportive tasks to ensure credentialing stays accurate and current. Serve as the escalation point for complex or delayed credentialing issues, engaging directly with payers and regulatory agencies as needed. Collaborate with Contracting, Billing, and AR teams to ensure credentialing data is correctly implemented and prevents claim denials. Provide regular reporting to leadership on credentialing performance metrics, compliance status, and provider network growth. Support and mentor team members (including a Credentialing Coordinator direct report if applicable), fostering accuracy, accountability, and professional development. Maintain detailed and organized documentation of applications, payer communications, and compliance activities for audit readiness. Identify and implement process improvements to streamline credentialing workflows and strengthen compliance. Use all internal systems proficiently and build new systems as needed. Build and maintain relationships with payer credentialing departments and be able to contact payers directly to resolve issues. Ensure adherence to HIPAA, payer, and regulatory requirements at all times. Performance Metrics: Provider Credentialing Turnaround: = 30 days for re-credentialing, = 90 days for new providers Clean Credentialing Application Submission Rate: >95% of applications accepted on first submission Provider Directory Accuracy: =98% accuracy across payer rosters and internal systems Error Prevention: All RCM teams routinely identify and fix root causes, preventing recurring denials Requirements Desired Qualifications and Experience: Bachelor’s degree in healthcare administration, business, or related field preferred. Minimum 3–5 years of experience in provider credentialing, payer enrollment, or healthcare compliance. Strong knowledge of payer credentialing requirements, CAQH, NPI, Medicaid/Medicare enrollment, and regulatory compliance standards. Proven ability to manage credentialing lifecycles with accuracy and efficiency. Demonstrated success achieving high clean submission rates and fast turnaround times. Strong organizational skills with the ability to manage multiple applications, rosters, and deadlines simultaneously. Excellent communication and relationship-building skills for interactions with payers, providers, and internal teams. Proficiency with credentialing databases, RCM/EHR systems, and Microsoft Office Suite. High attention to detail and commitment to accuracy and compliance. Strong problem-solving skills and persistence in resolving escalated issues. Essential Job Functions Must have manual dexterity to perform specific computer and electronic device functions Must have visual acuity to read and comprehend written communication though computer, electronic devices, and paper means. Must be able to maintain prolonged periods of working on a computer while sitting at a desk and attending virtual meetings Job Type: Non-Exempt, Full-Time Pay is competitive and based on candidate qualifications and experience. Full-time employees will be offered our comprehensive benefits including Paid Time Off, 401k, insurance (health, dental, and vision), and the option of Short and Long-Term disability insurance. About Bierman Autism Centers: Our goal is to fuse science and learning to accelerate progress and transform lives. We were established in 2006 with a simple focus on providing excellent therapy for children with autism and building a unique and fun environment for team members and children to thrive. We live by the culture we’ve created and our core values: to create a fun and stimulating learning environment, empower individuals and treat them with kindness, integrity, and respect, never sit still, achieve, and continuously raise the bar, team above the individual, build a sustainable organization that leaves a meaningful impact on lives, and adhere to our core principles without compromise. Bierman Autism Centers values diversity in the workplace. The company provides equal opportunity for employment and promotion to all qualified employees and applicants on the basis of experience, training, education, and ability to do the available work without regard to race, religion, color, age, sex/gender, sexual orientation, national origin, gender identity, disability, marital status, veteran status, genetic information, ancestry, or any other status protected by law. Furthermore, Bierman Autism Centers is committed to providing an equal opportunity workplace that is free of discrimination and harassment based on national origin, race, color, religion, gender, ancestry, age, sexual orientation, gender identity, disability, marital status, veteran status, genetic information, or any other status protected by law. As an equal opportunity employer, Bierman Autism Centers does not discriminate against qualified individuals with disabilities. If you require a reasonable accommodation as a candidate for employment, please inform a member of the Talent Acquisition team.

Responsibilities

The Credentialing Manager oversees provider onboarding and re-credentialing processes to ensure full compliance and timely access to care. They manage payer relationships, maintain provider directory accuracy, and lead process improvements to streamline credentialing workflows.