What are the responsibilities and job description for the Contracting & Credentialing Manager position at Agility Billing Services?
Agility Billing Services is a medical billing and revenue cycle management company supporting a growing portfolio of orthopedic, surgical, and specialty practice clients across the tri-state area. We’re building out a dedicated Contracting & Credentialing function, and we’re hiring a Contracting & Credentialing Manager to lead it.
This role owns payer contracting and provider credentialing/enrollment across our client portfolio, builds standardized processes for delivering that work at scale, and plays a direct role in strengthening our service offering as we grow.
Key Responsibilities
Payer Contracting - Lead negotiation, renewal, and management of managed care and commercial payer contracts (BCBS, UnitedHealthcare, Aetna, Cigna, Medicare/Medicaid MCOs, No-Fault/Workers’ Comp payers) across NY, NJ, and CT - Analyze fee schedules and contract terms to identify underpayment risk and negotiation opportunities - Track in-network status, contract renewal/termination windows, and payer relationships across multiple client accounts - Advise on No Surprises Act/IDR exposure tied to contracting gaps - Stay current on state-specific managed care regulations (NY DFS, NJ C.32/Maximus, CT DOI)
Credentialing & Provider Enrollment - Own end-to-end credentialing and re-credentialing for providers across client accounts — CAQH, NPI/PECOS, state licensure, malpractice/COI documentation - Build standardized workflows and tracking tools to support consistent turnaround and accuracy across accounts - Coordinate timely enrollment for newly hired providers to minimize revenue delays - Serve as primary liaison to payer provider relations/network management teams
Department Growth - Help define and refine this service line as part of the company’s broader growth strategy - Build onboarding processes for bringing new client accounts’ contracts and credentials into our systems efficiently - As the team grows, help hire, train, and manage credentialing/contracting staff - Report on contract performance, in-network status, and credentialing turnaround metrics
Qualifications
Required - 5 years of experience in healthcare payer contracting and/or provider credentialing - Working knowledge of the NY/NJ/CT managed care landscape and No Surprises Act/IDR framework - Hands-on experience with CAQH, PECOS/NPPES, and payer credentialing portals - Strong contract review and negotiation skills - Excellent organizational skills — comfortable managing multiple concurrent contracts and provider files - Proficiency in Excel and practice management/credentialing software
Preferred - CPCS (Certified Provider Credentialing Specialist) or CPMSM certification - CPC or similar coding/billing credential - Experience with orthopedic or surgical specialty reimbursement structures - Experience managing credentialing/contracting across multiple client accounts or practices - Familiarity with DrChrono, ModMed, or similar practice management/EHR systems
Compensation & Benefits
- Salary range: $85,000–$115,000, based on experience
- Medical, dental, and vision insurance
- 401(k) with employer contribution
- PTO paid holidays
- Professional certification/continuing education support
How to Apply
Submit resume and cover letter to Christine Pier [cpier@agilityrcm.com]. Please include any relevant credentialing certifications and a summary of payer contracts you’ve negotiated.
Salary : $85,000 - $115,000