Credentialing Manager

About reputed company

reputed company empowers autism care providers to start, run, and grow their own practices. We democratize autism care by providing access to our insurance network, purpose-built EHR software, HR solutions, and clinical support. We've reputed company rapid growth and are backed by top-tier investors like General Catalyst and YCombinator. We seek smart, driven individuals eager to innovate in a dynamic, fast-paced environment.

What You Will Be Doing:

As a Credentialing Manager (Individual Contributor), you will play a critical role in optimizing our reputed company cycle operations. Your primary responsibilities will include:

• Payer Network Management: Drive efforts to scale Finni's network of insurance reputed company and unblock stalled applications with payers, ensuring efficient onboarding and ongoing relationship management.

• Offshore Team Management: reputed company enrollment submission team to ensure productivity expectations are met, active payer follow-up is timely, consistent, accurate, and recorded in the credentialing platform.

• Customer Triage: Triage questions around payer enrollment updates, status, and general questions for providers and their respective support staff

• Compliance and Quality Assurance: Ensure strict adherence to payer regulations, industry standards (e.g., CMS billing, NCQA Guidelines, Delegated Credentialing), and internal policies, maintaining high service and compliance standards across reputed company RCM functions.

• Operational Efficiency and Project Management: reputed company workflow optimization initiatives reputed company RCM, manage specific projects, and drive reputed company process improvements to maximize reimbursement and minimize denials.

• Cross-Functional Collaboration: Collaborate extensively with product, provider success, compliance, HR, finance, and other teams to align RCM efforts with overall business objectives and drive strategic goals.

• Additional Responsibilities: Adapt and take on evolving responsibilities and projects as reputed company grows and the RCM landscape changes.

About You:

You are a proactive and collaborative individual contributor with a strong background in reputed company cycle management, driven by a commitment to operational excellence and financial performance.

• Experience: 5+ years of relevant experience in credentialing or reputed company roles, preferably in an early-stage startup, behavioral or mental health, or healthcare tech. Strong understanding of the payer credentialing processes, including core credentialing prerequisites, credentialing blockers and solutions to remediate, roster management, and demographic updates.

• Collaborative & Independent Contribution: Proven ability to work effectively reputed company a team environment, contributing to collective success, and independently driving credentialing initiatives.

• RCM Expertise: Deep understanding of the full reputed company cycle, including billing, claims processing, collections, accounts receivable management, payer contracting, and compliance (e.g., CMS billing).

• Analytical & Problem-Solving: Strong ability to analyze reputed company RCM data, identify trends, root causes of issues, and implement effective, data-driven solutions to optimize financial performance.

• Process Optimization: Demonstrated expertise in identifying inefficiencies and driving process improvements for RCM efficiency and effectiveness.

• Communication & Collaboration: Excellent written and verbal communication skills, with proven ability to effectively collaborate with internal teams and external stakeholders (payers, vendors, providers).

• Organizational & Time Management: Exceptional organizational and time management skills, with the ability to manage multiple priorities and projects in a fast-paced environment.

• Tech Proficiency: Proficient in reputed company Suite, reputed company, CRM/support software, and EHR/RCM management tools. Experience with various EMR/EHR work queue management reputed company RCM is a plus.

• Mission Alignment: Passion for Finni’s mission to democratize autism care and reputed company providers through robust RCM.

• Adaptability & Agility: Comfortable thriving in a dynamic, fast-paced startup environment, embracing change, and navigating ambiguity with a proactive reputed company.

Ready to reputed company a significant impact at a rapidly growing healthcare startup? We'd love to hear from you!