Credentialing Supervisor

About Innocura Nephrology

INNOCURA Nephrology is building an integrated national nephrology practice to advance innovation in patient care, strengthen practice operations, and empower nephrologists to thrive. This role will focus on serving multiple practices.

Job Summary
The Credentialing Supervisor is a working leader responsible for overseeing and executing all aspects of provider licensure, credentialing, recredentialing, and privileging. This role ensures that Physicians, Nurse Practitioners, Physician Assistants, and other licensed providers are properly enrolled with contracted payers and privileged at affiliated hospitals and dialysis units to support uninterrupted patient care and revenue cycle performance.

The Supervisor manages credentialing workflows, supports provider onboarding and expansion initiatives, and ensures compliance with regulatory and payer requirements. This position plays a critical role in maintaining operational efficiency, minimizing reimbursement delays, and strengthening the overall infrastructure of the practice.

Responsibilities

Leadership & Oversight

• Supervise and support credentialing staff and/or contracted credentialing vendors.
• Assign and prioritize workloads to meet onboarding and recredentialing timelines.·
• Develop, maintain, and improve credentialing policies, procedures, and tracking systems.
• Monitor key performance indicators (KPIs) related to credentialing turnaround times and payer enrollment.
• Identify process improvements to streamline provider enrollment and reduce revenue delays.

Provider Licensure & Enrollment

• Prepare, complete, and submit applications for:

- State licensure and renewals

- DEA registration

- CAQH maintenance and attestations

- Medicare, Medicaid, and commercial payer enrollment

• Manage initial credentialing and recredentialing cycles for all providers.
• Track and follow up on application statuses to ensure timely approvals.
• Maintain accurate provider demographic and credentialing data in internal systems.

Hospital & Facility Privileging

• Coordinate and submit hospital and dialysis unit privileging applications.
• Obtain and verify required documentation, including:

- Work history

- Peer references

- Board certification

- Malpractice coverage

• Serve as liaison between the practice and medical staff offices to resolve application issues.

Revenue Cycle & Operational Alignment

• Partner with Billing teams to ensure providers are enrolled prior to rendering services.
• Communicate enrollment status updates to leadership to mitigate billing risks.
• Support new provider onboarding timelines to align with patient scheduling and clinic operations.
• Assist with group contract additions and roster updates.

Compliance & Audit Readiness

• Maintain complete and audit-ready credentialing files.
• Monitor expiration dates for licenses, certifications, and insurance.
• Ensure compliance with payer, state, and federal regulations.
• Support internal and external audits as needed.

Process Improvement and Efficiency

• Assess process improvement opportunities within current workflows and systems.
• Integrate AI into workflows and be main point of contact for potential future vendor relationships.
• Coach team to achieve benchmark industry metrics such as time to completion, provider to credentialer ratios, and applications processed annually.

Knowledge, Skills, and Abilities

• Thorough knowledge of Medicare, Medicaid, and commercial payer credentialing processes.
• Strong understanding of medical practice operations and revenue cycle impact.
• Proficiency with credentialing databases, CAQH, PECOS, and practice management systems.
• Exceptional organizational skills and attention to detail.
• Ability to manage multiple providers and deadlines simultaneously.
• Strong communication and relationship management skills.
• Analytical approach to improving workflow efficiency

Education

• Bachelor’s degree in Healthcare Administration, Business, or related field preferred.
• Equivalent combination of education and experience will be considered.

Experience

• Minimum 5 years of experience in provider credentialing within a medical practice or healthcare organization.
• At least 1–2 years of supervisory or team leadership experience.
• Strong experience with payer enrollment and hospital privileging.
• Experience coordinating with revenue cycle or billing teams preferred.

Job Type: Full-time

Pay: $63,835.00 - $86,635.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Experience:

• credentialing: 5 years (Preferred)
• supervisory: 1 year (Preferred)

Work Location: Hybrid remote in Pittsburgh, PA 15224

Salary : $63,835 - $86,635