Provider Credentialing Specialist: Streamline Compliance

Automatic Data Processing, 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

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.