• Provide supervision, coaching, and engagement to ensure exceptional customer service and achievement of carrier, vendor, and insured KPIs. • Support the implementation of processes, policies, and team standards. • Role model for delivering an exceptional customer experience every time • Establish and maintain positive interactions with internal and external stakeholders. • Assist with overseeing and determining settlement authorizations for team. • Monitor the progress of files, claims, tasks, and queues to ensure compliance. • Adhere to and promote all customer service standards • Ensures sales team milestones and metrics are achieved • Other duties as required • Ability to work overtime or flex schedules during high volume and CAT Events is required

• Oversee day-to-day operations of a team consisting of all elements of the Credentialing process. • Assist in ensuring the coordination of initial and ongoing compliance with National Committee for Quality Assurance (NCQA) and Delta Dental Plans Association standards. • Ensures development and execution of Credentialing and other provider onboarding functions in accordance with applicable department policies and procedures. • Work directly with provider services associates, providers and external clients to ensure satisfaction and timeliness. • Generate performance measures and set goals while monitoring performance against them. • Coordinate directly with the Director of Compliance to ensure alignment with all departmental and company initiatives. • Monitor key performance indicators and metrics to assess provider enrollment & credentialing effectiveness, efficiency, and compliance. • Responsible for continuous process improvement in provider enrollment and credentialing processes. • Maintain all providers’ contractual credentialing information for all Networks including Medicare Advantage and Medicaid. • Run regularly scheduled reports to identify and address any outstanding applications, issues, and expiring information. • Assist in development, implementation and maintenance of processes that support department and organization goals.

• Supervise and monitor the daily activities of Support team members, ensuring adherence to KPIs and company performance goals. • Provide guidance and mentorship to direct reports, ensuring professional growth and high performance aligned with business objectives. • Act as a resource for the Support team, answering questions and assisting with issue resolution. • Monitor and review employee performance, providing feedback and support as needed to drive improvement in key metrics. • Identify and escalate any concerns related to team performance or workflow inefficiencies to management. • Collaborate with cross-functional teams to resolve escalated issues. • Assist in resolving customer grievances and mentor employees through complex support scenarios. • Conduct regular quality assurance (QA) evaluations and check-ins for direct reports, ensuring alignment with KPIs. • Maintain strict confidentiality regarding sensitive employee information.

• Oversee and support daily workflows for charge entry, coding coordination, and edit resolution. • Work collaboratively with coders and clinical teams to ensure charges are accurate, complete, and compliant prior to claim submission. • Review edit and rejection reports regularly, ensuring timely and accurate resolution of front-end claim errors. • Identify recurring issues related to coding, provider documentation, or charge entry and escalate trends to the RCM Manager. • Serve as a liaison between coding staff and providers to support documentation improvement and code accuracy. • Work closely with the Patient A/R Supervisor to ensure front-end data integrity supports clean patient balances and minimizes billing issues. • Partner with the Back-End Supervisor to align workflows related to edits, denials, and payer rejections that originate from front-end errors. • Collaborate with the RCM Manager to implement changes in workflows based on payer policy updates, denial trends, and compliance findings. • Monitor payer-specific edit trends and address root causes of front-end claim rejections or delays. • Audit charge entry, coding interfaces, and edit resolution activities to identify and correct quality issues. • Ensure timely documentation of resolution steps taken on rejected or held charges. • Assist in onboarding, training, and mentoring staff in front-end processes and payer-specific rules.