Credentialing Supervisor: Provider Enrollment Lead

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

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.