Credentialing Customer Success Manager

About the role

Plutus Health Inc., a leading Revenue Cycle Management provider, is looking for a Credentialing Customer Success Manager to oversee end‑to‑end credentialing for healthcare providers. The role bridges our U.S. clients, offshore support team, and payer organizations to ensure timely onboarding and compliance.

Key responsibilities

• Manage initial credentialing, re‑credentialing, and enrollment for providers across Medicare, Medicaid, and commercial payers.
• Act as primary liaison between clients and offshore team, guaranteeing SLA adherence.
• Maintain up‑to‑date provider profiles and resolve missing documentation by coordinating with clients and payers.
• Conduct outreach to payer enrollment departments to expedite applications.
• Verify licenses, certifications, education, and work history for accuracy.
• Support sales initiatives and contribute to credentialing meetings and process‑improvement projects.
• Maintain credentialing trackers, dashboards, and ensure data integrity.
• Assist with audits and uphold HIPAA and payer‑specific compliance.

Required profile

• 10+ years of U.S. provider credentialing experience.
• Strong organizational and communication abilities.
• Ability to work independently, manage multiple priorities, and maintain meticulous attention to detail.

Required skills

• Proficiency with CAQH, PECOS, NPPES, OIG, SAM, Medicaid Exclusion, Medicare Opt‑Out List, and Social Security Death Master File.
• Experience using payer portals such as UHC, BCBS, Cigna, Humana, and state Medicaid systems.
• Advanced Microsoft Excel and credentialing database expertise.
• Familiarity with credentialing dashboards and Excel‑based trackers.