Credentialing Manager at DeCoach Rehabilition Center – Cincinnati, Ohio

DeCoach Recovery Centre, a local leader in addiction treatment, is currently hiring for a Credentialing Manager to work in our Sharonville headquarters. The Credentialing Manager plays a critical role in ensuring that all healthcare providers within the organization meet the necessary professional standards and regulatory requirements to be credentialed. This position is responsible for overseeing the credentialing process, including verification of qualifications, licensure, and compliance with industry standards to maintain the integrity and reputation of DeCoach Recovery Centre. The manager will lead a team dedicated to managing provider data, conducting primary source verifications, and maintaining accurate records to support provider enrollment and reimbursement processes. Collaboration with internal departments and external regulatory bodies is essential to ensure timely and accurate credentialing activities. Ultimately, the Credentialing Manager ensures that the organization’s providers are fully credentialed and compliant, enabling the delivery of safe, high-quality patient care across all service lines.

Minimum Qualifications:

• A degree in healthcare administration, business, or a related field is preferred but not required.
• Minimum of 3 years of experience in healthcare credentialing or provider enrollment.
• Strong knowledge of credentialing standards.
• Experience with credentialing software and databases.
• Excellent organizational skills with the ability to manage multiple priorities and deadlines.

Preferred Qualifications:

• Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) certification.
• Experience managing a credentialing team in a multi-facility healthcare environment.
• Familiarity with payer enrollment processes and insurance verification.
• Advanced proficiency in data management and reporting tools, including Microsoft Excel and database software.
• Strong understanding of healthcare compliance and regulatory environments.

Responsibilities:

• Manage and oversee the end-to-end credentialing and re-credentialing processes for all healthcare providers in compliance with regulatory and accreditation standards.
• Lead and develop a team responsible for verifying provider qualifications, licenses, certifications, and work history through primary source verification.
• Maintain accurate and up-to-date credentialing files and databases, ensuring all documentation is complete and audit-ready.
• Collaborate with human resources, compliance, and clinical departments to facilitate provider enrollment with insurance payers and regulatory agencies.
• Monitor changes in credentialing regulations and industry best practices to update policies and procedures accordingly.
• Prepare and present regular reports on credentialing status, compliance metrics, and process improvements to senior leadership.
• Address and resolve any credentialing issues or discrepancies in a timely and professional manner.

Benefits:

• Medical, Dental and Vision Insurance Plans
• A company Matched 401K plan
• Yearly Merit Raises
• Paid Holidays and PTO plan
• Tuition Reimbursement
• Opportunities for Advancement
• STAR Eligible Facilities