Credentialing Specialist

ADP, Inc.; Johnson Place (WV); On-site; USD 40,000 - 60,000; Full time

Job summary

Automatic Data Processing, Inc. is seeking a Credentialing Specialist in Scott Depot, WV. You will handle credentialing and re-credentialing for providers, ensuring accurate provider data and license compliance.

Responsibilities include managing applications, maintaining licenses and certifications, tracking expirations, and updates to health plan requirements. This is a full-time, on-site role.

Qualifications

• High school graduate or equivalent.
• Excellent customer service, telephone, and computer skills.
• Knowledge of credentialing and re-credentialing process.

Responsibilities

• Site and Provider Credentialing:
• Complies and maintains current and accurate data for all providers
• Completes provider credentialing and re-credentialing applications, monitors applications and follow-up as needed
• Maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers
• Maintains knowledge of current health plan requirements for credentialing providers
• Completes setup and maintains provider information in online credentialing databases
• Tracks license and certifications expiration for all providers
• Ensures practice addresses are current with all health plans
• Maintains collaborative agreements with providers

Skills

Customer service

Telephone

Computer skills

Credentialing knowledge

Education

High school diploma or equivalent

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Credentialing Specialist

Billing Full Time Scott Depot, WV, US

Physical Requirements:

The employee is regularly required to talk, hear, and sit. Repetitive arm, hand, and finger movements are regularly required. The employee is frequently required to stand, walk, stoop, and reach. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, color vision, and the ability to adjust focus. This is NOT a remote position.

Qualifications:

High school graduate or equivalent. Excellent customer service, telephone, and computer skills. Knowledge of credentialing and re-credentialing process.

Basic Function:

Responsible for all aspects of the credentialing and re-credentialing processes for all providers who provide patient care at WomenCare Inc dba FamilyCare Health Center and all locations.

Duties and Responsibilities:

Site and Provider Credentialing:

• Complies and maintains current and accurate data for all providers
• Completes provider credentialing and re-credentialing applications, monitors applications and follow-up as needed
• Maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers
• Maintains knowledge of current health plan requirements for credentialing providers
• Completes setup and maintains provider information in online credentialing databases
• Tracks license and certifications expiration for all providers
• Ensures practice addresses are current with all health plans
• Maintains collaborative agreements with providers