Credentialing Manager

Brief Description

Southern Ear, Nose, Throat and Allergy (SENTA) physicians provide the highest quality allergy, asthma, immunology and otolaryngology care through our network of practices.

SENTA Partners is a leading Management Services Organization (MSO) specializing in providing comprehensive support to ENT and Allergy private practices. Our mission is to help people Breathe better, Hear better, Live better. At SENTA, we focus on the operational efficiencies and financial performance of our partner practices, allowing physicians to focus on delivering exceptional patient care. We are committed to fostering a collaborative and supportive work environment where our employees can thrive and grow.

Position Overview

The Credentialing Manager at SENTA Partners is responsible for overseeing and managing the credentialing and re-credentialing process for healthcare providers within our organization. This role ensures that all providers meet the necessary regulatory, payer, and accreditation standards to deliver high-quality patient care. The Credentialing Manager works closely with providers, practice managers, and insurance companies to maintain compliance and manage all credentialing activities effectively. Please note this is an in-office environment.

Key Responsibilities

Credentialing & Enrollment Management

• Oversee end-to-end credentialing and re-credentialing for all providers.
• Manage submission and tracking of applications for credentialing, re-credentialing, and payer enrollment.
• Liaise with insurance companies and regulatory bodies to ensure timely, accurate completion.
• Monitor expirations of licenses, certifications, and credentials to maintain compliance.
  
  
  

Policy, Compliance & Quality Assurance

• Develop and maintain credentialing policies aligned with regulations and best practices.
• Conduct audits of provider files to ensure compliance with accreditation, regulatory, and payer requirements.
• Track and report credentialing timelines, addressing delays or issues proactively.
  
  
  

Data & Systems Management

• Maintain a comprehensive provider database with current credentialing documentation.
• Generate reports and analytics to track performance and support decision-making.
• Identify and implement process improvements to enhance efficiency and accuracy.
  
  
  

Collaboration & Leadership

• Partner with providers, practice managers, billing, and compliance teams to streamline credentialing and enrollment.
• Provide training and guidance on credentialing requirements and best practices.
• Lead and support the credentialing team through mentorship and performance management.
  
  
  

What We Offer

• Comprehensive Health Benefits (Medical, Dental, and Vision)
• Health Savings Account (HSA)
• Flexible Spending Account (FSA)
• Short & Long Term Disability
• Holidays & Paid Time Off (PTO)
• Employee Assistance Program (EAP)
• Retirement Contribution Program - 401(K) Match
  
  
  

Requirements

Qualifications

• Bachelor’s degree in Healthcare Administration, Business Administration, or a related field preferred.
• Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) certification is preferred.
• 5 years of experience in credentialing, with at least 2 years in a leadership or management role.
• Strong knowledge of credentialing processes, regulatory requirements, and payer enrollment procedures.
• Proven ability to manage complex credentialing workflows and maintain strict attention to detail.
• Strong organizational and time management skills, with the ability to manage multiple priorities and meet deadlines.
• Proficiency with credentialing software and databases.
• Experience in a multi-location healthcare environment is a plus.
• Ability to adapt to changing regulations and industry standards.
  
  
  

Summary

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• Certain US jurisdictions require SENTA Partners to provide new employees with a reasonable estimate of the salary for this role at the location in which the job may be performed. The posted salary range reflects our best estimate at the time of posting, though it's important to remember that actual salaries may vary. Factors that determine the final salary offer include office location, experience, skills, and current organizational needs.
• SENTA Partners is an equal opportunity employer and considers all qualified applicants for employment without regard to race, color, religion, sex, national origin, disability, veteran status, sexual orientation, gender identity, or any other protected status.