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Credentials Manager Jobs in Illinois (NOW HIRING)

Akumincorp

Specialist, HR Credentialing

Carbondale, IL · On-site

Manage and process the HR Credentialing inbox to meet or exceed agreed internal SLA. * Support all metric reporting efforts by ensuring all trackers are updated timely including customer requests ...

FriendHealth

HR Credentialing Coordinator

Chicago, IL · On-site

Verify provider credentials through primary source verification. * Maintain compliance with FQHC ... Ability to manage multiple deadlines independently. SMART GOALS (OUTCOMES) * Achieve and maintain a ...

PeopleShare LLC

Recruiter

Bolingbrook, IL · On-site

Create and update payroll records, pay rates, job assignment information and electronic time entry credentials * Manage temporary associates on assignments. Handle staffing emergencies, job coaching ...

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Credentials Manager information

What is a credentials manager?

A Credentials Manager is a professional responsible for overseeing, maintaining, and securing access credentials such as passwords, certificates, and digital keys within an organization. Their role typically involves implementing policies and systems that ensure only authorized individuals can access sensitive information or systems. They may use credential management software to automate password changes, monitor usage, and enforce security protocols. Credentials Managers play a critical role in protecting an organization's data and preventing unauthorized access.

What skills and qualifications are needed to thrive as a credentials manager?

To thrive as a Credentials Manager, you need strong organizational skills, attention to detail, and a solid understanding of compliance and credentialing processes, often supported by a degree in business administration or a related field. Familiarity with credentialing software systems, databases, and knowledge of industry standards such as NCQA or Joint Commission requirements is essential. Excellent communication, problem-solving abilities, and discretion are valuable soft skills for managing sensitive information and coordinating with diverse stakeholders. These skills ensure accurate credential management, regulatory compliance, and smooth operations in organizational environments.

What are common challenges faced by a credentials manager, and how can they be addressed?

A Credentials Manager often encounters challenges such as keeping up with frequently changing regulatory requirements, managing large volumes of sensitive data, and ensuring timely renewals for staff credentials. Staying organized with robust tracking systems and maintaining clear communication with team members can help prevent lapses or compliance issues. Additionally, adopting credentialing software and regular training on industry standards can significantly reduce errors and improve efficiency in the role.

What is the difference between Credentials Manager vs Credential Analyst?

AspectCredentials ManagerCredential Analyst
Required credentialsCertifications in security, IT, or compliance; experience in credential management systemsCertifications in data analysis, security, or compliance; knowledge of credential standards
Work environmentCorporate, IT departments, security teamsCompliance departments, security teams, data analysis units
Employer and industry usageUsed in IT, security, and corporate compliance sectorsCommon in security, compliance, and auditing fields
Search and comparison intentUnderstanding roles related to credential management and securityAnalyzing credential data and compliance status

While both roles involve handling credentials, a Credentials Manager primarily oversees the secure storage and management of credentials within organizations, focusing on security and access control. A Credential Analyst, on the other hand, analyzes credential data for compliance, validation, and auditing purposes. Both roles are vital in security and compliance sectors but serve different functions within organizations.

Is credentialing a hard job?

Credentialing is a detailed and organized role that involves verifying qualifications, licenses, and certifications of healthcare providers or professionals. It requires attention to accuracy, knowledge of industry standards, and often involves working with databases and documentation, making it moderately challenging depending on the complexity of the credentialing process. Strong organizational skills and familiarity with credentialing software can help manage the workload effectively.

What are the most commonly searched types of Credentials jobs in Illinois?

The most popular types of Credentials jobs in Illinois are:

What cities in Illinois are hiring for Credentials Manager jobs?

Cities in Illinois with the most Credentials Manager job openings:

Credentials Manager jobs near you

Credentialing Team Lead

Des Plaines, IL • On-site

Orthodontic Experts LTD
1 - 10 employees
Learn more about Orthodontic Experts LTDexternal

$25/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 21 days ago

Job description

Job Type
Full-time
Description
About us:
At Orthodontic Experts, we are committed to delivering exceptional patient care and setting the standard for orthodontic excellence. With 32 locations across the greater Chicagoland area, Wisconsin, and Indiana, and continued growth ahead, we are focused on transforming smiles and making a meaningful impact in the communities we serve.
We are looking for team members who are passionate about high-quality care and align with our Core Values:
  • Accountability
  • Continuous Improvement
  • Inclusion
  • Integrity
  • Respect
  • Teamwork
  • Transparency

If you are seeking an opportunity to grow your career in a purpose-driven, patient-centered organization, we encourage you to apply.
Job Description:
We are seeking an experienced Orthodontic Provider Credentialing Team Lead to support provider enrollment, credentialing, recredentialing, payer maintenance, and provider data management for a growing orthodontic healthcare organization. This role helps ensure providers are enrolled accurately and efficiently with commercial insurance plans, Medicaid, and other third-party payers so providers can begin seeing patients without unnecessary delays.
The right candidate is detail-oriented, organized, proactive with payer follow-up, and comfortable managing multiple applications, deadlines, and provider documentation at the same time.
Duties include but are not limited to:
  • Serve as the primary resource for credentialing inquiries from internal departments, providers, insurance payers, and external partners.
  • Lead the credentialing and recredentialing process for orthodontic providers to ensure uninterrupted payer participation.
  • Coordinate and manage provider enrollment applications from preparation and submission through approval and implementation.
  • Facilitate credentialing and payer enrollment for newly affiliated practices and providers to support timely onboarding.
  • Organize and maintain provider credentialing records, ensuring all supporting documentation, renewal dates, and compliance requirements remain current.
  • Maintain and update provider documentation, including professional licenses, NPI records, malpractice insurance, curriculum vitae (CV), specialty certifications, CPR/BLS certifications, W-9 forms, and other required credentials.
  • Create, maintain, and attest CAQH profiles, upload required documentation, and authorize payer access as necessary.
  • Administer provider enrollment and ongoing participation with commercial insurance carriers, Medicare, Medicaid, managed Medicaid plans, and other assigned payers.
  • Manage provider lifecycle updates, including new enrollments, terminations, demographic changes, ownership transitions, tax identification updates, and practice location changes.
  • Ensure compliance with payer-specific enrollment requirements and maintain all required documentation for commercial and government health plans.
  • Maintain Illinois Medicaid enrollment through the iMPACT system or other applicable state enrollment platforms.
  • Manage the credentialing database and related software systems by entering, validating, and maintaining provider information, enrollment status, credentialing milestones, expiration dates, payer communications, and supporting documentation to ensure data accuracy, regulatory compliance, and timely reporting.
  • Track credentialing applications, document payer correspondence, monitor approval timelines, and identify outstanding requirements to ensure timely completion.
  • Proactively communicate with insurance payers to obtain status updates, resolve issues, and keep credentialing applications moving through the approval process.
  • Provide regular updates on credentialing progress, milestones, risks, and potential delays to leadership and other key stakeholders.
  • Present credentialing status, trends, key metrics, and insights to internal stakeholders and external partners to support informed decision-making.
  • Build and maintain strong working relationships among Business Development support teams, practice leadership, office staff, Human Resources, Revenue Cycle, Operations, and insurance payers to promote efficient credentialing workflows.
  • Collaborate cross-functionally to ensure providers are credentialed, enrolled, and participating with payers in alignment with organizational onboarding timelines.
  • Develop, implement, and maintain standard operating procedures (SOPs), process documentation, and workflow guidelines for the credentialing department to promote consistency, regulatory compliance, operational efficiency, and continuous process improvement.
  • Stay informed of evolving credentialing regulations, payer requirements, and developments within the dental industry to ensure ongoing compliance and adherence to best practices.
  • Identify opportunities to enhance credentialing workflows, improve turnaround times, streamline provider enrollment processes, leverage technology, and support the organization's continued growth and operational excellence.

Requirements
  • High school diploma or equivalent.
  • At least 2 years of healthcare credentialing, provider enrollment, or payer enrollment experience.
  • Experience with practice management and provider enrollment systems
  • Ability to manage deadlines, documentation, follow-up, and multiple payer applications at once.
  • Strong written and verbal communication skills.
  • Proficiency with Microsoft Office, including Excel, Word, and Outlook.
  • Previous Team Lead experience required

Preferred Qualifications
  • Associate's or bachelor's degree in healthcare administration, Business Administration, or a related field.
  • Experience in multi-location healthcare practices, specialty practices, or a healthcare services organization.
  • Experience with Illinois Medicaid iMPACT, CAQH, payer portals, EFT/ERA enrollment, and insurance contract management.

Working Hours/ Location:
  • Location: 1700 W Higgins Rd Des Plaines, IL 60018
  • Full-Time/Non-exempt
  • Hours: 8:00 AM to 5:00 PM

Benefits (for our full-time employees):
  • Paid Training
  • Paid Time Off
  • Holiday Pay
  • Medical, Dental, Vision, and Life Insurance
  • Accident Insurance
  • Short-Term Disability
  • Long-Term Disability
  • Employee Assistance Program
  • Health Savings Account
  • Dependent Care Account
  • 401(k) and matching
  • Pet Insurance
  • Tuition Assistance Program
  • Identity Theft Protection
  • MetLife MetLaw Legal Insurance
  • Transit Reimbursement - Commuter Account
  • Free and discounted Orthodontic Treatments

Salary Description
$25.00 per hour

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