Credentialing Customer Success Manager
Company: Calpion/Plutus Health
Location: Addison
Posted on: April 1, 2026
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Job Description:
About Plutus Health Inc.: Plutus Health Inc. is a leading
provider of Revenue Cycle Management (RCM) services, certified in
SOC2 compliance and recognized among the Inc. 5000 fastest-growing
private companies. We specialize in revenue cycle optimization for
hospitals, physician groups, and healthcare organizations across
various specialties. Our commitment to innovation and excellence
has earned us recognition as a 2024 EY Entrepreneur Of The Year
finalist and one of the top 100 fastest-growing companies in
Dallas. Role Summary Plutus Health is seeking a detail-oriented and
proactive Credentialing Specialist to join our U.S. credentialing
team. You will be responsible to work with offshore team in
providing the end-to-end credentialing process for healthcare
providers, ensuring compliance with payer requirements and
regulatory standards. This role is critical to maintain operational
efficiency and timely provider onboarding across multiple clients
and specialties. Key Responsibilities Should have a good
understanding of initial credentialing, re-credentialing, and
enrollment processes for providers across Medicare, Medicaid, and
commercial payers. Serve as the communication bridge between the
client and the offshore team to ensure service level agreements
(SLAs) are consistently met Work with offshore team in making sure
provider profiles are kept up to date. Collaborate with the
offshore team to identify missing documentation and coordinate with
the client to obtain the required information Initiate phone calls
and build rapport with the payer enrollment department to
accelerate the application process Verify provider credentials
including licenses, certifications, education, and work history.
Collaborate with the sales team to support and enhance sales
initiatives Coordinate with internal teams and clients to gather
required documentation and resolve discrepancies. Maintain
credentialing trackers and ensure data accuracy. Support audits and
ensure compliance with HIPAA and payer-specific guidelines.
Participate in credentialing meetings and contribute to process
improvement initiatives. Requirements 10 years of experience in
U.S. provider credentialing. Familiarity with CAQH, PECOS, NPPES,
and payer-specific portals (e.g., Anthem, Optum, Medicaid MCOs).
Strong organizational and communication skills. Proficiency in
Microsoft Excel, credentialing databases, and tools. Preferred
Attributes Experience handling credentialing for various
specialties and multi-state providers. Ability to work
independently and manage multiple priorities. Strong attention to
detail and commitment to data accuracy. Familiarity with
payer-specific credentialing nuances and timelines. Tools & Systems
CAQH, PECOS, NPPES, OIG, SAM, MEDICAID EXCLUSION, MEDICARE OPT OUT
LIST, SOCIAL SECURITY DEATH MASTER FILE. Payer portals including
UHC, BCBS, Cigna, Humana, State Medicaid. Credentialing dashboards
and Excel-based trackers. Why Join Plutus Health Inc.? Work for a
fast-growing, innovative company recognized for excellence in
healthcare. Collaborate with a dynamic, supportive team that values
professional development. Make a meaningful impact on patient care
and operational success.
Keywords: Calpion/Plutus Health, Irving , Credentialing Customer Success Manager, IT / Software / Systems , Addison, Texas
