Credentialing Manager

About the Company

At Sleep Doctor, we’re helping millions get a full night's rest. As the most trusted name in sleep health, we make better sleep possible with proven support, clear answers, and hands-on care that fits real life. Across our brands—SleepDoctor.com, SleepFoundation.org, and SleepApnea.org—we combine clinical expertise with consumer-first experiences to help people understand their sleep, tackle real challenges, and wake up to healthier, more energized lives.

Responsibilities

• Maintain strict alignment with NCQA, URAC, Joint Commission, CMS, and state regulatory guidelines
• Design, implement, and audit internal quality control processes to ensure zero gaps in provider files
• Serve as the lead coordinator for all external facility and plan audits
• Manage relationships with major commercial insurance plans, Medicare, and Medicaid
• Monitor key performance indicators (KPIs) like "Days to Enroll" and resolve complex application rejections
• Collaborate with Compliance, Billing, Legal, Clinical and Revenue operations teams to troubleshoot claim denials
• Oversee the accuracy and security of the credentialing database
• Ensure CAQH profiles, NPPES data, and state license renewals are updated systematically
• Oversee the full lifecycle of state-level licensing, including medical boards, DEA, and facility-level DME licenses

Requirements

• Minimum of 6+ years of healthcare credentialing experience
• 1–2 years in a supervisory or lead specialist role
• CPCS (Certified Provider Credentialing Specialist) or CPMSM (Certified Professional Medical Services Management) required
• Mastery of CAQH, PECOS, and standard credentialing software
• Bachelor’s degree in Healthcare Administration, Business Administration, or related field preferred
• Exceptional attention to administrative detail and strong verbal communication skills

Benefits

• Medical, vision, and dental insurance
• Medical and dependent care FSA options
• 401(k) plan with matching contributions
• Paid Time Off
• Commuter benefits (Seattle-based employees)