Credentialing Manager at Sleep Doctor

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Full Time

Start Date

Immediate

Expiry Date

13 Oct, 26

Salary

90000.0

Posted On

15 Jul, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Provider Credentialing, Provider Enrollment, Regulatory Compliance, Audit Coordination, KPI Monitoring, Database Management, State Licensing, CAQH, PECOS, NPPES, Insurance Relationship Management, Team Leadership, Administrative Detail, Verbal Communication, Confidential Data Handling, Quality Control

Industry

Wellness and Fitness Services

Description

About Us At Sleep Doctor, we’re helping millions get a full night's rest. As the most trusted name in sleep health, we make better sleep possible with proven support, clear answers, and hands-on care that fits real life. Across our brands—SleepDoctor.com, SleepFoundation.org, and SleepApnea.org—we combine clinical expertise with consumer-first experiences to help people understand their sleep, tackle real challenges, and wake up to healthier, more energized lives. If you’re passionate about making better sleep possible—and want to help reshape the future of sleep care—we’d love to meet you. The Role Sleep Doctor is seeking a detail-oriented, highly organized, and proactive Credentialing Manager to oversee our organization's provider credentialing and enrollment processes. In this role, you will lead a dedicated team of specialists, ensuring all medical staff are fully compliant with federal, state, and institutional regulations. You will own the full lifecycle of provider enrollment with commercial and government payers, troubleshoot systemic bottlenecks, and serve as the primary point of contact for external audits. What You’ll Do Every Day Maintain strict alignment with NCQA, URAC, Joint Commission, CMS, and state regulatory guidelines. Design, implement, and audit internal quality control processes to ensure zero gaps in provider files. Serve as the lead coordinator for all external facility and plan audits. Manage relationships with major commercial insurance plans, Medicare, and Medicaid. Monitor key performance indicators (KPIs) like "Days to Enroll" and proactively resolve complex application rejections to protect organizational cash flow. Collaborate closely with the Compliance, Billing, Legal, Clinical and Revenue operations teams to troubleshoot credentialing-related claim denials. Oversee the accuracy and security of the credentialing database Ensure CAQH profiles, NPPES data, and state license renewals are updated systematically across the entire roster. Oversee the full lifecycle of state-level licensing, managing both individual provider credentials (state medical boards, DEA, and controlled substance certificates) and facility-level DME operating licenses, out-of-state distribution permits, and surety bond renewals across all active markets. What You Bring to the Role Minimum of 6+ years of healthcare credentialing experience, with at least 1–2 years in a supervisory or lead specialist role. Bachelor’s degree in Healthcare Administration, Business Administration, or a related field preferred (equivalent direct experience will be considered). CPCS (Certified Provider Credentialing Specialist) or CPMSM (Certified Professional Medical Services Management) is required. Mastery of CAQH, PECOS, and standard credentialing software. Exceptional attention to administrative detail, strong verbal communication (for negotiating with insurance representatives), and proven ability to handle sensitive, confidential provider information. Who We Are We play an important role in the health & wellness decisions of our audiences, and it’s a responsibility we don’t take lightly. We invest thoughtfully to provide the most expert-driven, audience-first experience We embody rapid, sustainable growth. Run into a challenge or a new opportunity? Everyone on the team rolls up their sleeves and digs in. We’re going to push you to ask big questions and find bold answers. Everyone has a seat at the table, regardless of their title or job description In Seattle, our positions adopt a hybrid model, recognizing the importance of in-person collaboration and remote work. Our newly renovated-office remains open five days a week to those who thrive in a traditional office-environment We love a good celebration! We enjoy what we do because of who we do it with, and take time to celebrate every win – whether ours or a teammate’s Compensation Range $75,000 - $90,000. Note that final compensation is subject to the candidate’s specific qualifications and location, as well as the needs of the company. The Company currently provides medical, vision, and dental insurance with XX% of the employee medical, vision, and dental premiums covered by the Company. There is an option to participate in both a medical FSA and dependent care FSA. We offer a 401(k) plan, with fully matching contributions up to 3% of salary and 50% matching from 3% to 5% of salary. You will be eligible for Paid Time Off in accordance with the company’s policies. Our Seattle-based employees will receive commuter benefits. Sleep Doctor is committed to bringing together individuals from diverse backgrounds and perspectives. We strive to create an inclusive environment where everyone can thrive and be their authentic self, feel a sense of community, and do great work together. We are proud to be an equal opportunity employer open to all qualified applicants

Responsibilities

Oversee the full lifecycle of provider credentialing and enrollment while ensuring compliance with federal, state, and institutional regulations. Lead a team of specialists to manage insurance relationships, handle external audits, and maintain accurate provider databases.