Credentialing Manager
Finni Health (YC W23) · United States · 1 wk ago
RemoteRemoteInformation Technology$70k–$85k/yrFull-time
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
- 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.
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.
- You have 5+ years of relevant experience in credentialing or related roles, preferably in an early-stage startup, behavioral or mental health, or healthcare tech.
- You have a strong understanding of the payer credentialing processes, including core credentialing prerequisites, credentialing blockers and solutions to remediate, roster management, and demographic updates.
- You have Medicaid experience is required.
- You have proven ability to work effectively within a team environment, contributing to collective success, and independently driving credentialing initiatives.
- You have deep understanding of the full revenue cycle, including billing, claims processing, collections, accounts receivable management, payer contracting, and compliance (e.g., CMS billing).
- You have strong analytical and problem-solving skills, able to analyze complex RCM data, identify trends, root causes of issues, and implement effective, data-driven solutions to optimize financial performance.
- You have demonstrated expertise in identifying inefficiencies and driving process improvements for RCM efficiency and effectiveness.
- You have excellent written and verbal communication skills, with proven ability to effectively collaborate with internal teams and external stakeholders (payers, vendors, providers).
- You have exceptional organizational and time management skills, with the ability to manage multiple priorities and projects in a fast-paced environment.
- You are 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.
- You have passion for Finni’s mission to democratize autism care and empower providers through robust RCM.
- You are comfortable thriving in a dynamic, fast-paced startup environment, embracing change, and navigating ambiguity with a proactive mindset.
Compensation Range
$70K - $85K