Credentialing Manager

🔥 2 minutes ago

🇺🇸 United States – Remote

💵 $70k - $85k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 8%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Finni Health (YC W23)

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2022

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance • Mental Health

Finni Health is a nationwide provider of expert ABA (Applied Behavior Analysis) and mental health care designed for families navigating autism. By connecting families with highly qualified therapists, Finni offers personalized support that includes in-home or in-clinic services, flexible scheduling, and family-led goal setting. With a commitment to results-based care, Finni is dedicated to improving the lives of children with autism and their families through dedicated therapy that enhances daily living skills, communication, and emotional regulation.

📋 Description

• Drive efforts to scale Finni Health's network of insurance contracts and unblock stalled payer applications • Oversee the enrollment submission team and ensure timely, consistent, accurate payer follow-up recorded in the credentialing platform • Triage provider and support-staff questions about payer enrollment updates and status • Ensure adherence to payer regulations, CMS billing, NCQA Guidelines, Delegated Credentialing, and internal policies • Lead RCM workflow optimization initiatives and manage projects to maximize reimbursement and minimize denials • Collaborate with product, provider success, compliance, HR, finance, and other teams • Take on evolving responsibilities and projects as Finni Health grows

🎯 Requirements

• 5+ years of relevant experience in credentialing or related roles • Experience in healthcare credentialing or provider enrollment • Strong understanding of payer credentialing processes, including credentialing prerequisites, blockers and remediation, roster management, and demographic updates • Medicaid experience is required • Deep understanding of the full revenue cycle, including billing, claims processing, collections, accounts receivable management, payer contracting, and compliance • Ability to analyze complex RCM data, identify trends and root causes, and implement data-driven solutions • Expertise in identifying inefficiencies and driving RCM process improvements • Excellent written and verbal communication skills • Exceptional organizational and time management skills; ability to manage multiple priorities and projects • Proficiency in Google Suite, Slack, CRM/support software, and EHR/RCM management tools • Experience with EMR/EHR work queue management within RCM is a plus • Ability to work collaboratively and independently in a dynamic, fast-paced startup environment • Must be authorized to work in the United States