Credentialing Specialist – Drive Provider Compliance & Growth

Mountain State Oral & Facial Surgery; Hurricane (WV); On-site; USD 42,000 - 56,000; Full time

Benefits offered by this job

Health Care Plan (Medical, Dental &amp

Retirement Plan (401k, IRA)

Life Insurance (Basic, Voluntary & AD&

Flexible Benefits Plan (FSA, HSA)

Tuition Assistance

Continuing Education

Annual Scrub Allowance

Paid Time Off (Vacation & 6 Holidays)

Family Leave (Maternity, Paternity)

Short Term & Long Term Disability

Training & Development

Free Food & Snacks

Wellness Resources

Job summary

Mountain State Oral & Facial Surgery in Hurricane, WV seeks a Credentialing Specialist to manage provider credentialing packages and renewals with hospitals, payers, Medicare, and Medicaid. The candidate will maintain provider files and ensure accurate records.

Responsibilities include license applications, revalidations, and updating CAQH/PECOS/NPPES/CMS profiles, while supporting a team in a fast-paced clinical setting with a strong focus on accuracy and timelines.

Qualifications

• 5 years credentialing experience
• 5 years Microsoft Office experience
• 5 years knowledge of AAAHC, NCQA, and TDI

Responsibilities

• Maintain individual provider files with up-to-date credentialing information
• Maintain internal provider grid ensuring accuracy and logins
• Apply for and renew provider licenses (Professional, DEA, etc.) annually
• Complete revalidation requests by government payers
• Complete credentialing applications for hospitals, commercial payers, Medicare, and Medicaid
• Re-credentialing for commercial payers and hospitals
• Maintain provider profiles on CAQH, PECOS, NPPES, and CMS databases
• Other duties as assigned

Skills

Credentialing knowledge

Excellent communication

Detail oriented

Organizational skills

Deadline driven

Team collaboration

Education

High School Diploma or equivalent

Tools

MS Office

Job description

Mountain State Oral & Facial Surgery in Hurricane, WV seeks a Credentialing Specialist to manage provider credentialing packages and renewals with hospitals, payers, Medicare, and Medicaid. The candidate will maintain provider files and ensure accurate records.

Responsibilities include license applications, revalidations, and updating CAQH/PECOS/NPPES/CMS profiles, while supporting a team in a fast-paced clinical setting with a strong focus on accuracy and timelines.