Senior Credentialing Manager

Position: Senior Credentialing Manager

Work setup & shift: WFH and Nightshift

Why join MicroSourcing?

Youll Have

• Competitive Rewards: Enjoy above-market compensation, healthcare coverage on day one, plus one or more dependents, paid time-off with cash conversion, group life insurance, and performance bonuses
• A Collaborative Spirit: Contribute to a positive and engaging work environment by participating in company-sponsored events and activities.
• Work-Life Harmony: Enjoy the balance between work and life that suits you with flexible work arrangements.
• Career Growth: Take advantage of opportunities for continuous learning and career advancement.
• Inclusive Teamwork: Be part of a team that celebrates diversity and fosters an inclusive culture.
  
  

Your Role

Credentialing & Re-Credentialing Management (50%)

• Manage the complete credentialing lifecycle for all providers across client practices
• Submit initial credentialing applications to commercial payers, Medicare, Medicaid, and other insurance networks
• Track and manage re-credentialing timelines to ensure continuous payer enrollment without lapses
• Coordinate with providers to collect required documentation (licenses, certifications, DEA, malpractice insurance, etc.)
• Follow up with payers on application status and resolve credentialing delays or issues
• Maintain credentialing databases with accurate, up-to-date provider information
• Payer Enrollment & Provider Information Management (25%)
• Facilitate payer enrollment for new providers joining client practices
• Work with payers to update provider information (address changes, practice locations, taxonomy codes)
• Assist with CAQH profile creation, maintenance, and attestation
• Provide credentialing documentation and status updates to support leaderships contract discussions
• Coordinate with billing managers to ensure proper payer setup in practice management systems
  
  

Compliance & Documentation (15%)

• Ensure all provider credentials meet federal, state, and payer-specific requirements
• Monitor license and certification expiration dates and proactively notify providers of renewals
• Maintain organized credentialing files for audit readiness and regulatory compliance
• Track and document all credentialing communications and status updates
• Prepare credentialing reports for AVP, Directors, and client practices
  
  

Client & Provider Support (10%)

• Serve as primary point of contact for credentialing questions from providers and practice staff
• Educate providers on credentialing requirements, timelines, and best practices
• Coordinate with billing managers to resolve revenue cycle issues related to credentialing delays
• Provide status updates to clients on pending credentialing applications
• Troubleshoot credentialing-related claim denials and rejections
• Account & Workload
• Providers Managed: 20-40 providers across multiple client practices
• Credentialing Applications: 5-10 active applications at any given time
• Re-credentialing Cycle: Manage ongoing 3-year re-credentialing cycles for all providers
• Independence Level: 85-90% (escalate complex payer issues to AVP/Director; contract negotiations are handled by leadership)
  
  

What You Need

• 3-5 years of medical credentialing experience in physician practices, hospitals, or RCM companies
• Proven track record managing credentialing for multiple providers and payer networks
• Experience with CAQH, Medicare/Medicaid enrollment, and commercial payer credentialing processes
• Strong understanding of provider taxonomy codes, NPI numbers, and payer enrollment requirements
• Proficiency with credentialing software and databases (e.g., CAQH ProView, Credsy, or similar platforms)
• Experience with practice management systems (ECW, Advanced MD, ModMed, Tebra, Dr. Chrono, etc.)
• Strong data management and organizational skills with attention to detail
• Proficiency in Microsoft Office Suite (Excel, Word) and Google Workspace
• Deep knowledge of federal and state credentialing regulations and compliance requirements
• Understanding of medical specialties, procedures, and taxonomy codes
• Preferred: CPCS (Certified Provider Credentialing Specialist) or CPMSM certification
• Familiarity with Joint Commission, NCQA, and other accreditation standards
  
  

About MicroSourcing

With over 9,000 professionals across 13 delivery centers, MicroSourcing is the pioneer and largest offshore provider of managed services in the Philippines.

Our commitment to 100% YOU

MicroSourcing firmly believes that our companys strength lies in our peoples diversity and talent. We are proud to foster an inclusive culture that embraces individuals of all races, genders, ethnicities, abilities, and backgrounds. We provide space for everyone, embracing different perspectives, and making room for opportunities for each individual to thrive.

At MicroSourcing, equality is not merely a slogan – its our commitment. Our way of life. Here, we dont just accept your unique authentic self - we celebrate it, valuing every individuals contribution to our collective success and growth. Join us in celebrating YOU and your 100%!

For more information, visit https://www.microsourcing.com/

• Terms & conditions apply

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