Credentialing Supervisor

The Primary Health Network; Sharon (Mercer County); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

Short-term disability

Retirement plan

Paid time off

College savings plan

Fitness center membership

IDShield & LegalShield

Job summary

The Primary Health Network is seeking a Credentialing Supervisor to oversee the credentialing team and manage insurance enrollment, credentialing, recredentialing, and privileging processes. This role ensures providers are enrolled, credentialed, and refreshed with licenses and certifications.

Based in Mercer County, the position offers a Monday–Friday schedule and a collaborative environment within the Credentialing and Billing Department.

Qualifications

• High school diploma or equivalent.
• Three years of credentialing experience.
• Strong communication and organizational skills.
• Computer proficiency.

Responsibilities

• Supervise credentialing specialists.
• Compile and maintain current provider data.
• Oversee credentialing and recredentialing applications; monitor and follow up.
• Ensure copies of current state licenses and DEA certificates are up to date.
• Stay updated on health plan and agency credentialing requirements.
• Set up and maintain provider information in credentialing databases.
• Monitor license and certification expirations for timely renewals.
• Ensure practice addresses are current with health plans and agencies.
• Build relationships with provider relations reps at insurance companies.
• Review insurance updates and attend meetings with carriers.
• Review claims denied for credentialing issues and coordinate resolutions.
• Maintain confidentiality and integrity of information.
• Perform other related duties as assigned.

Skills

Credentialing

Supervision

Communication skills

Organizational skills

Education

High school diploma

Job description

Credentialing Supervisor (Full Time )
Location: Mercer County

POSITION SNAPSHOT

Site / Department: Credentialing and Billing Department

Schedule: Monday – Friday 8:30am – 5:00pm

WHY THIS ROLE

The Credentialing Supervisor provides oversight of the credentialing specialists and all aspects of insurance enrollment, credentialing, recredentialing, and privileging processes for PHN providers. This role helps ensure providers are appropriately enrolled, credentialed, appointed, and privileged with health plans, hospitals, and patient care facilities while maintaining accurate provider information and timely license and certification renewals.

WHAT YOU'LL DO

• Supervise credentialing specialists.
• Compile and maintain current and accurate data for all providers.
• Oversee completion of provider credentialing and recredentialing applications; monitor applications and follow up as needed.
• Ensure copies of current state licenses and DEA certificates are maintained.
• Stay abreast of current health plan and agency requirements for credentialing providers.
• Set up and maintain provider information in online credentialing databases and systems.
• Monitor license and certification expirations for all providers to ensure timely renewals.
• Ensure practice addresses are current with health plans, agencies, and other entities.
• Build strong working relationships with provider relations representatives at insurance companies.
• Review insurance updates and attend meetings with insurance carrier representatives.
• Review claims rejected due to credentialing issues and work with appropriate companies for resolution.
• Maintain confidentiality and integrity of all information.
• Perform other related duties as assigned.

WHAT WE'RE LOOKING FOR

• High school diploma or equivalent.
• Three years of relevant credentialing experience.
• Strong communication and organizational skills.
• Computer proficiency.

BENEFITS

• Medical, dental and vision coverage - employee and family plans available; eligible immediately upon start
• Employer-paid short-term disability
• Retirement plan
• Paid time off
• College savings plan
• Fitness center membership reimbursement
• IDShield & LegalShield

ABOUT PRIMARY HEALTH NETWORK

Primary Health Network is the largest Federally Qualified Health Center (FQHC) in Pennsylvania. Our mission is to provide quality primary care services and access to specialty care for the people in the communities we serve.

Accessibility Support for Applicants

Primary Health Network is committed to providing equal access to employment opportunities.

If you experience difficulty accessing our careers site or completing an application, or if you require a reasonable accommodation due to a disability, please contact us at [e-mail]. Our team will work with you to provide an accessible alternative application process.