Proficio Speech Therapy Group, Inc.
Website:
proficiotherapy.com
Job details:
Who We Are
Proficio Therapy Services is a mission driven therapy organization dedicated to improving the lives of children and families. We provide high quality ABA Therapy, Speech Therapy, and Occupational Therapy through our family of licensed clinical entities:
- AGES Learning Solutions LLC ABA Therapy
- Proficio Speech Therapy Group Inc Speech Therapy
- Childs Play Therapy Services PC – Occupational Therapy
Today, we operate 11 clinics across the United States, supported by more than 250 clinicians. We are actively expanding into additional cities throughout California and Utah, with international growth underway in India and the Middle East.
Our teams are backed by strong clinical leadership, reliable operational systems, and a culture built on respect, inclusion, and collaboration. Whether you’re starting your career or stepping into leadership, you’ll find opportunities to grow, contribute, and make a meaningful impact every day.
At Proficio, your work truly matters and so does your growth. Join us as we continue building a unified, global therapy organization dedicated to empowering children and families.
Job Summary
The Credentialing Manager is responsible for leading and managing the end-to-end provider credentialing, recredentialing, and payer enrollment functions for healthcare providers across the US healthcare system. This role ensures providers are credentialed, enrolled, and maintained with commercial insurance payers, Medicare, Medicaid, and other healthcare networks to support uninterrupted billing and reimbursement. The Credentialing Manager oversees credentialing operations, manages team workloads, drives process improvements, ensures compliance with payer and regulatory requirements, and collaborates with cross-functional teams to support timely provider onboarding and organizational growth.
Responsibilities and Duties
- Lead and oversee the end-to-end credentialing and recredentialing process for BCBAs, SLPs, OTs, and other healthcare providers.
- Manage provider enrollment, revalidation, and participation with commercial insurance payers, Medicare, Medicaid, and other healthcare networks.
- Coordinate both individual and group provider enrollments, ensuring timely completion of all credentialing activities.
- Ensure providers are fully credentialed and enrolled before beginning client services to prevent delays in service delivery and reimbursement.
- Oversee the preparation, submission, tracking, and follow-up of credentialing and enrollment applications, proactively resolving issues that may impact turnaround times.
- Maintain regular communication with payer representatives, provider enrollment teams, and regulatory agencies to monitor application status and resolve outstanding requirements.
- Monitor credentialing effective dates and ensure providers are accurately added to payer directories and enrollment systems.
- Maintain complete, accurate, and audit-ready provider records, including licenses, certifications, malpractice insurance, NPI information, and all required credentialing documentation.
- Manage credentialing trackers, monitor application turnaround times, and ensure timely renewals to avoid credentialing lapses.
- Assign workloads, prioritize credentialing applications, and allocate team resources based on organizational hiring needs and business priorities.
- Provide leadership, guidance, and operational support to the credentialing team while ensuring high standards of accuracy, efficiency, and compliance.
- Develop, implement, and continuously improve credentialing workflows, standard operating procedures (SOPs), and operational processes to enhance efficiency and scalability.
- Investigate and resolve credentialing discrepancies, enrollment delays, application denials, and payer-related issues.
- Ensure compliance with CMS regulations, NCQA standards, payer requirements, and organizational policies throughout the credentialing lifecycle.
- Collaborate closely with Revenue Cycle Management, Human Resources, Clinical Operations, Compliance, Recruiting, and Provider Relations teams to support seamless provider onboarding and ongoing credentialing operations.
- Generate and review credentialing metrics and operational data to identify improvement opportunities and ensure service level expectations are consistently met.
- Stay informed of changes to payer requirements, credentialing regulations, provider enrollment guidelines, and industry best practices, implementing updates as needed across credentialing operations.
Qualifications
- Bachelor's degree in Healthcare Administration, Business Administration, Life Sciences, or a related field.
- 5+ years of experience in US Healthcare Credentialing, Provider Enrollment, or Medical Staff Services is required.
- Prior experience leading or managing credentialing operations or credentialing teams is preferred.
- Strong knowledge of provider credentialing, recredentialing, payer enrollment, and healthcare compliance requirements.
- Hands-on experience with CAQH, NPI Registry, PECOS, state Medicaid portals (e.g., PAVE), Availity, and payer-specific credentialing portals.
- Excellent organizational, communication, and stakeholder management skills with the ability to manage multiple priorities.
- Proficiency in Microsoft Office Suite, credentialing software, and provider enrollment systems.
Work Schedule
- Full-Time – Hybrid (Kochi)
- Night Shift to support US operations and payer working hours.
- Ability to collaborate with US-based teams and accommodate operational requirements as needed.
Work Environment
- Fast-paced healthcare operations supporting ABA and therapy services.
- Regular interaction with insurance payers, healthcare providers, licensing boards, and internal stakeholders.
- Collaborative environment requiring strong leadership, attention to detail, and the ability to manage multiple priorities while supporting organizational growth.
Compensation & Benefits
- Salary: 70k-80k per month
- Annual Performance Bonus.
- Medical Insurance Coverage.
- Paid Time Off.
- Opportunity to lead and scale credentialing operations within a rapidly growing international healthcare organization.
Equal Employment Opportunity
Proficio Speech Therapy is an Equal Opportunity/Affirmative Action employer committed to building a team that represents the racial, ethnic and linguistic needs of our clients.
This position description intends to describe the general nature and level of work being performed. It is not intended to include all duties and responsibilities. Because of a need to remain responsive to the needs of our clients and operational needs, job description and responsibilities may be modified at any time.
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