[Hiring] Credentialing Manager @Finni Health

Role Description

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.

Qualifications

• 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.
• Proven ability to work effectively within a team environment, contributing to collective success, and independently driving credentialing initiatives.
• Deep understanding of the full revenue cycle, including billing, claims processing, collections, accounts receivable management, payer contracting, and compliance (e.g., CMS billing).
• Strong ability to analyze complex RCM data, identify trends, root causes of issues, and implement effective, data-driven solutions to optimize financial performance.
• Demonstrated expertise in identifying inefficiencies and driving process improvements for RCM efficiency and effectiveness.
• Excellent written and verbal communication skills, with proven ability to effectively collaborate with internal teams and external stakeholders (payers, vendors, providers).
• Exceptional organizational and time management skills, with the ability to manage multiple priorities and projects in a fast-paced environment.
• 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.
• Passion for Finni’s mission to democratize autism care and empower providers through robust RCM.
• Comfortable thriving in a dynamic, fast-paced startup environment, embracing change, and navigating ambiguity with a proactive mindset.

Company Description

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.