Credentialing Account Manager

Summary

Cognizant is a technology and engineering company seeking a Credentialing Account Manager to manage client relationships and oversee provider credentialing and payer enrollment operations. The role serves as the primary client contact, coordinates enrollments with payers, maintains accurate provider data, ensures compliance, resolves issues, and supports process improvements.

Responsibilities

• Serve as the primary point of contact for assigned clients regarding credentialing and payer enrollment activities
• Manage the end-to-end provider enrollment lifecycle, including initial enrollments, revalidations, demographic updates, maintenance requests, and payer terminations
• Coordinate with commercial and government payers to facilitate timely provider enrollment and resolve enrollment-related issues
• Maintain accurate provider records, supporting documentation, databases, and case notes
• Monitor account performance and provide regular status updates, reporting, and communication to clients and internal stakeholders
• Investigate and resolve enrollment issues, escalations, and payer-related challenges to ensure successful outcomes
• Ensure compliance with payer requirements, regulatory standards, and company policies
• Participate in process improvement initiatives and support operational excellence across credentialing and enrollment functions

Skills

• 1+ year of healthcare credentialing, provider enrollment, or payer enrollment experience
• Strong understanding of provider credentialing and payer enrollment processes
• Experience working with commercial and government health plans
• Knowledge of provider lifecycle management, enrollment maintenance, and revalidation requirements
• Experience utilizing credentialing and enrollment platforms such as CAQH, PECOS, NPPES, Medicaid portals, Availity, and payer-specific systems
• Excellent client relationship management, communication, and interpersonal skills
• Strong organizational skills with the ability to manage multiple accounts, priorities, and deadlines
• High attention to detail and strong problem-solving capabilities
• Experience supporting large healthcare organizations, medical groups, or healthcare services providers
• Knowledge of Medicare, Medicaid, and commercial payer enrollment requirements
• Experience analyzing enrollment metrics and productivity reports
• Familiarity with healthcare regulations and compliance standards related to provider enrollment
• Experience working in a fast-paced, client-facing healthcare operations environment
• Demonstrated ability to identify process improvement opportunities and implement operational efficiencies

Qualifications

Must Haves

• 1+ year of healthcare credentialing, provider enrollment, or payer enrollment experience
• Strong understanding of provider credentialing and payer enrollment processes
• Experience working with commercial and government health plans
• Knowledge of provider lifecycle management, enrollment maintenance, and revalidation requirements
• Experience utilizing credentialing and enrollment platforms such as CAQH, PECOS, NPPES, Medicaid portals, Availity, and payer-specific systems
• Excellent client relationship management, communication, and interpersonal skills
• Strong organizational skills with the ability to manage multiple accounts, priorities, and deadlines
• High attention to detail and strong problem-solving capabilities

Nice to Haves

• Experience supporting large healthcare organizations, medical groups, or healthcare services providers
• Knowledge of Medicare, Medicaid, and commercial payer enrollment requirements
• Experience analyzing enrollment metrics and productivity reports
• Familiarity with healthcare regulations and compliance standards related to provider enrollment
• Experience working in a fast-paced, client-facing healthcare operations environment
• Demonstrated ability to identify process improvement opportunities and implement operational efficiencies

Benefits

• This position is also eligible for Cognizant’s discretionary annual incentive program, based on performance and subject to the terms of Cognizant’s applicable plans.
• This position is fully remote, allowing you to work from your home office while collaborating with clients, providers, payers, and internal teams in a virtual environment.
• Support a healthy work-life balance through our wellbeing programs.