RadNet · 2 days ago
Credentialing Manager
United States
Full-time
Remote
Senior Level
7+ years expRadNet is a leading radiology company focused on delivering quality patient care. The Indiana Credentialing Manager is responsible for overseeing all aspects of credentialing and privileging processes for medical providers, ensuring compliance with regulatory standards and facilitating efficient credentialing operations across multiple locations.
Health CareHealth DiagnosticsHospitalMedical
Responsibilities
Responsible for ensuring providers are credentialed, appointed, and privileged with health plans, hospitals and patient care facilities
Ensure that the personnel/providers of a RadNet facility, or RadNet affiliated professional corporation (PC) are properly trained, licensed and certified as mandated by state and federal regulations. In addition, ensure that all services offered by these facilities and providers meet standards set by state and federal government agencies
Ensures continued high levels of performance with regulatory, accreditation, and internal requirements including but not limited to CAQH, NCQA, DOI, Medicaid, CMS
Provides leadership and oversight of development, documentation and implementation of a IN accreditation plan that includes auditing, coordination of multiple required program processes, such as education and training
Lead, manage and ensure that all credentialing specialists review applications, verify both individual and facility accreditation, maintain records of verification and work with auditors as needed
Ensure the resolution of Claim Holds, Clearinghouse rejections and denials related to credentialing & provider enrolment issues in a timely manner to avoid delays and loss revenue
Maintains copies of all current licenses, DEA certificates, malpractice coverage and any other required documents for all providers
Maintains Verity and ECHO OAP databases in which new information or update existing information regarding employee training, licenses, education, continuing education and relevant job experience
Ensure that all necessary licenses and credentials are verified and updated for the healthcare facility in which they work. This might include conducting background checks, contacting licensing boards, reviewing license applications, obtaining education information and interviewing references
Qualification
Required
At least seven years of experience in health care credentialing, insurance verification, appeals negotiations and processing in the health care industry, health care billing/claims processing, and data processing and software operations in the health care industry
Exceptions to years of experience above, may be made given extensive industry related experience of at least 5 years radiology credentialing and progressive team management experience
Requires a comprehensive understanding Commercial health plans, Medicare and Medicaid health plans
Extensive knowledge of medical coding, CPT and HCPCS codes and ICD 10, direct radiology coding knowledge preferred
Comprehensive understanding of medical management and health insurance concepts, information management systems and strong analytical and problem-solving skills are required
Strong Excel data analysis skills and proficiency with Microsoft Office applications
Strong written, verbal and interpersonal communication skills
Preferred
Bachelor's degree in healthcare administration highly preferred
Company
RadNet
RadNet provides diagnostic imaging services through a network of 400 owned and operated outpatient imaging centers.
10001+ employees
Funding
Current Stage
Public CompanyTotal Funding
$1.71BKey Investors
Barclays
2025-06-11Post Ipo Debt· $100M
2024-04-11Post Ipo Debt· $1.16B
2024-03-07Post Ipo Equity· $230.2M
Leadership Team
Norman Hames
President & CEO, Western Operations
Stephen Forthuber
President & CEO - Eastern Operations
Recent News
2026-01-08
2026-01-08
2026-01-07
Company data provided by crunchbase