Credentialing Operations Manager
Knack RCMRepublic Of India, IN2 hours ago
Job descriptionEstablish and maintain process documentation, SOPs, and performance trackers. Monitor quality and turnaround time (TAT) and implement corrective actions when required. Ensure all credentialing processes comply with NCQA, CMS, and payer-specific regulations. Identify process gaps and recommend automation or standardization opportunities. Serve as a primary point of contact for clients, addressing escalations and ensuring satisfaction. Collaborate with cross-functional departments (Operations, IT, HR, Quality) to support smooth functioning of credentialing workflows. Conduct regular business review meetings (internal & client-facing) to present performance and improvement metrics. Track and report KPIs including application submission, approval rates, and error percentages. Generate weekly / monthly performance reports and share insights for leadership review. Bachelor’s degree in Healthcare, Business Administration, or related field (Master’s preferred). Minimum 8 years of RCM experience with at least 3 years in credentialing management. Prior experience in client handling and process transition will be an added advantage. Work with one of the most trusted and established names in the RCM industry. Opportunity to lead a growing credentialing vertical with strong client exposure. Transparent, performance-driven environment with structured growth path. Employee-friendly culture that values skill, ownership, and innovation.
About the Role :
The Manager – Provider Enrollment & Credentialing will be responsible for overseeing the end-to-end provider enrollment, credentialing, and re-credentialing processes for healthcare providers across multiple payers.
This role involves managing a team, ensuring compliance with payer and regulatory requirements, maintaining strong client relationships, and driving process efficiency and quality across all credentialing operations.
Location : Mohali (On-site)
Key Responsibilities :
Team & Operations Management
- Lead and mentor the Credentialing and Provider Enrollment team, ensuring productivity, accuracy, and adherence to SLAs.
- Oversee day-to-day operations related to CAQH management, payer applications, NPI, and Medicare / Medicaid enrollments.
- Manage re-credentialing, demographic updates, and enrollment follow-ups with payers.
- Ensure completion of applications, verifications, and documentation within defined timelines.
Process Improvement & Compliance
Client & Stakeholder Communication
Reporting & Metrics
Qualifications :
Why Join Knack RCM :
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Operation Manager • Republic Of India, IN