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Credentialing Manager

Role overview

Qualifications

  • 5+ years of relevant experience in credentialing or related roles
  • Strong understanding of the payer credentialing processes
  • Excellent written and verbal communication skills
  • Proficient in Google Suite, Slack, CRM/support software, and EHR/RCM management tools

Responsibilities

  • Drive efforts to scale Finni's network of insurance contracts and unblock stalled applications with payers
  • Oversee enrollment submission team to ensure productivity expectations are met
  • Ensure strict adherence to payer regulations, industry standards, and internal policies
  • Lead workflow optimization initiatives within RCM and manage specific projects

Key facts

Other skills

  • Collaboration
  • Communication
  • Teamwork
  • Time Management
  • Problem Solving
  • Adaptability

About the company

Inersia AE. Consultant, PT logo

Inersia AE. Consultant, PT

PT. INERSIA AMPAK ENGINEERS is a limited corporate established since 1976 which is specialized in consultancy services. The firm is supported by professional in various disciplines. INERSIA past and recent record has proven that we have capability to implement projects with various degrees of difficulties and covered a vast area at district, province and national level. The Firm assignment came from individual various institutions, from Government-owned, national and international companies including privates/individuals. These assignments covering various scope of work such as Planning and Design, Construction Management, Supervision, Feasibility Study, Project Management, Community Development, Capacity Building, Training and Human Resources Development, Monitoring and Evaluation, Management Information System, Project Evaluation, Research and Development, Social, Health and Environment Study. Most of projects are funded through several foreign donor agencies and for these assignments PT. Inersia Ampak Engineers is associating with other international consultant firm from Canada, Australia, Japan, Germany and USA.

Company details

Company size11 - 50

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Job description

About Finni Health

Finni Health 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 experienced 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 revenue cycle operations. Your primary responsibilities will include:

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

  • Offshore Team Management: Oversee 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 all RCM functions.

  • Operational Efficiency and Project Management: Lead workflow optimization initiatives within RCM, manage specific projects, and drive continuous 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 Finni Health grows and the RCM landscape changes.

About You:

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

  • Experience: 5+ years of relevant experience in credentialing or related 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. Medicaid experience is required.

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

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

  • Analytical & Problem-Solving: Strong ability to analyze complex 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 Google Suite, Slack, CRM/support software, and EHR/RCM management tools. Experience with various EMR/EHR work queue management within RCM is a plus.

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

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


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

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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