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Contracting & Credentialing Manager
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Rancho Physial Therapy
Remote
$62,500 Salary, Full-Time
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Job Description
Contracting & Credentialing Manager Rancho Physial Therapy Menifee, CA Job Details Full-time $60,000 - $65,000 a year 3 days ago Benefits Health savings account Disability insurance Health insurance Dental insurance Paid time off Parental leave Employee assistance program Vision insurance Life insurance Referral program Qualifications Teamwork Medicare Provider enrollment for medical credentialing CMS regulatory compliance Health insurance knowledge Attention to detail Centers for Medicare and Medicaid Services (CMS) Medicaid regulations Medicaid Business Administration Business Associate's degree Full Job Description Summary Overview We are seeking a highly organized and results-driven Contracting & Credentialing Manager to lead all payer contracting, credentialing, recredentialing, and provider enrollment activities for our growing Physical Therapy organization. This critical role ensures that therapists and clinical staff maintain active credentials, payer participation, and regulatory compliance, supporting uninterrupted patient care and timely reimbursement. As the primary liaison between the organization, insurance payers, credentialing agencies, and internal stakeholders, the Contracting & Credentialing Manager will oversee contract development, negotiation, implementation, and maintenance while ensuring adherence to legal, regulatory, and organizational standards. The ideal candidate combines strong analytical skills, attention to detail, and healthcare industry expertise to optimize payer relationships, mitigate risk, and support revenue cycle performance. Key Responsibilities Payer Contracting Manage and maintain all payer contracts, including commercial insurance, Medicare, Medicaid, and workers' compensation plans. Lead contract negotiations, renewals, and amendments to ensure competitive reimbursement rates and favorable terms. Analyze contract terms, fee schedules, and reimbursement methodologies; identify financial risks and opportunities. Maintain a centralized repository of all contracts and track renewal timelines. Credentialing & Enrollment Oversee initial credentialing, recredentialing, and payer enrollment for all physical therapists and applicable clinical staff. Ensure timely submission of complete and accurate credentialing applications to payers and CAQH. Track license renewals, certifications, malpractice coverage, NPI, and other required documentation. Monitor credentialing timelines to prevent lapses that could delay or deny reimbursement. Compliance & Regulatory Oversight Ensure compliance with state licensure requirements, Medicare/Medicaid regulations, and payer-specific credentialing standards. Stay current on regulatory changes impacting credentialing, contracting, and reimbursement in physical therapy. Support audits, payer inquiries, and accreditation or regulatory reviews as needed. Collaboration & Revenue Cycle Support Work closely with billing, coding, and front-office teams to resolve payer enrollment or credentialing-related claim issues. Serve as a subject matter expert for payer participation status and provider eligibility questions. Support new clinic openings, acquisitions, or provider onboarding by coordinating contracting and credentialing activities. Qualifications Associate or Bachelor's degree in Healthcare Administration, Business Administration, or a related field (or equivalent experience). 2 + years of experience in healthcare credentialing and payer contracting, preferably in a physical therapy, rehab, or outpatient setting. Strong working knowledge of Medicare, Medicaid, and commercial payer credentialing and enrollment processes. Experience with CAQH, NPI, and state licensure requirements. High attention to detail with strong organizational and follow-up skills.