Senior Credentialing Operations Specialist

As a Senior Credentialing Operations Specialist, you will leverage your advanced technical knowledge in credentialing alongside leadership skills to manage large provider portfolios efficiently. Your role involves mentoring junior team members, overseeing daily operational workflows, and ensuring smooth credentialing processes across multiple healthcare accounts. This position requires a proactive approach to optimize workflows and collaborate closely with medical billing teams to support revenue cycle management.

Key Responsibilities

Operations Management: Manage the complete lifecycle of provider enrollment, re-credentialing, and profile maintenance for various U.S. healthcare accounts. Ensure accuracy and timeliness throughout these processes to maintain compliance and operational effectiveness.

Team Leadership & Mentoring: Provide guidance and support to junior team members, assist with complex credentialing escalations, and perform administrative tasks as assigned by management. Foster a collaborative environment that encourages professional growth.

Workflow Optimization: Develop and refine tracking systems for provider licenses, DEA renewals, and board certifications. Implement measures to prevent lapses and ensure continuous credentialing compliance.

Revenue Cycle Management (RCM) Integration: Work closely with medical billing teams to identify and resolve revenue bottlenecks caused by provider enrollment errors. Facilitate communication between departments to streamline billing and credentialing alignment.

Reporting: Prepare and deliver regular reports detailing credentialing throughput, pipeline status, and operational metrics to support data-driven decision-making.

Required Qualifications

Education: Bachelor’s degree in Business Administration, Healthcare Management, or a related field.

Experience: Between 3 to 5 years of experience in U.S. provider credentialing and medical billing. Prior experience in leadership or mentoring roles is highly desirable.

Communication: Excellent spoken and written English skills are essential for effective team leadership and correspondence with U.S.-based stakeholders.

Personal Traits: Strong organizational abilities, the capacity to remain calm under pressure, and proven multitasking skills are critical for success in this role.

Work Schedule: This position operates on a night shift schedule from 5:30 PM to 2:30 AM, Monday through Friday.

Work Location: This is an in-person role based at the company’s office.

Candidates should be prepared to discuss their credentialing experience, current and expected salary, notice period status, willingness to work night shifts, and commuting feasibility during the application process.