Credentialing Supervisor

Precision Orthopedics & Sports Medicine

Credentialing Supervisor

Location: Fulton, MD

Position Type: Full-time - Mon-Fri

About the Company :

Founded in 2012, Precision Orthopedics & Sports Medicine is a private practice group of board-certified and fellowship-trained orthopedic surgeons who focus on individualized care of their patients. We have 18 locations in the DMV area and meet the orthopedic needs of our patients with prompt appointments and caring staff. Specialized physicians delivering personalized orthopedic care.

Comprehensive care that's conveniently located close to home. With locations spread across Maryland, Virginia, and D.C., Precision Orthopedics & Sports Medicine offers our premier services to residents throughout the DMV area. You won't have to go far to get the quality orthopedic care you need. We also partner with leading local hospitals to ensure coordinated care delivery for treatments that may require surgery or physical therapy.

Position Summary:

The Credentialing Supervisor manages daily credentialing operations, oversees staff performance, and ensures compliance with payer, regulatory, and accreditation standards. This role supports provider onboarding, maintains credentialing data accuracy, and drives workflow efficiency. Also to bridge the gap between provider enrollment and financial billing. They ensure healthcare providers are legally permitted to treat patients and that the facility is accurately paid for those services.

Essential Duties & Responsibilities:

• Credentialing Management - Oversee initial credentialing, recredentialing, primary source verification, and expirables tracking.
• Staff Supervision - Lead credentialing team; assign tasks, monitor productivity, and provide coaching.
• Regulatory Compliance and Licensing - Ensure adherence to NCQA, CMS, Joint Commission, and payer requirements. Maintain provider records for NPI, CAQH, PECOS, state licenses, DEA, board certifications, and renewals.
• Quality Review - Audit credentialing files for accuracy, completeness, and timely processing.
• Process Improvement - Identify workflow gaps and implement operational enhancements.
• Provider & Payer Communication - Serve as point of contact for credentialing status, requirements, and issue resolution. Prepare, submit, and track payer applications, rosters, and follow ups.
• Data Management - Maintain credentialing databases; update provider records; generate reports.
• Cross-Functional Collaboration - Coordinate with HR, compliance, revenue cycle, and clinical leadership.
• Document Management- Coordinate efficient document scanning and organization for record keeping.

Required Qualifications

• Experience - 3-5 years credentialing experience; supervisory or lead experience preferred.
• Certification - CPCS or CPMSM Preferred
• Healthcare Background - Experience in medical group, hospital, or payer credentialing preferred.
• Technical Skills - Credentialing software, CAQH, payer portals, MS Office.
• Regulatory Knowledge - NCQA, CMS, commercial payer standards.
• Core Competencies - Attention to detail, time management, communication, problem-solving.

Employee Benefit Overview:

• Vacation time & Sick time
• 9 paid major holidays
• CareFirst medical coverage
• Dental and Vision coverage
• Voluntary Life and Short-term Disability coverage
• Tuition assistance for continued education
• Health Savings Account (HSA)
• Flexible Spending Account (FSA)
• 401k Retirement Plan
• Mileage Reimbursement

EOE