Provider Data Specialist — Remote Credentialing & Enrollment

General Dynamics Information Technology, Inc.; Georgia; Hybrid; USD 73,000 - 99,000; Full time

Benefits offered by this job

401K match

Health & wellness

Paid vacation & holidays

Paid family leave

Disability & life insurance

Education & certifications

Internal mobility team

Remote-friendly environment

Job summary

General Dynamics Information Technology, Inc. is seeking a Provider Data Representative to ensure complete, accurate provider demographic, participation, credentialing, enrollment, roster, and directory data across WTCHP systems.

The role partners with Provider Relations, Credentialing, Provider Data, Claims Operations, and Contracting to maintain data integrity and support timely claims processing. You will drive data quality, support audits, and generate reports for leadership, while helping

Qualifications

• Bachelor’s degree preferred.
• 3+ years of experience in provider data, credentialing, enrollment, or health plan operations.
• Strong analytical skills and proficiency in Microsoft Excel.
• Exceptional attention to detail and accuracy.

Responsibilities

• Directory Accuracy & Completeness: Maintain high accuracy standards for provider directory data.
• Support issue resolution that reduces member and provider complaints arising from directory discrepancies.
• Timely Updates & Maintenance: Process demographic changes, additions, terminations, and updates within service‑level expectations.
• Reduce backlog and improve turnaround time through efficient workflow management.
• Data Integrity Management: Validate and maintain NPIs, TINs, specialties, practice locations, affiliations, licensure, and EFT data.
• Identify and reduce claims‑impacting data error rates; support audit readiness.
• Roster Reconciliation: Reconcile provider rosters against credentialing, enrollment, claims, and directory systems.
• Identify discrepancies affecting participation or claims payment and coordinate timely correction with cross‑functional teams.
• Credentialing & Enrollment Support: Validate provider demographic data required for onboarding, credentialing, and recredentialing.
• Identify and resolve participation or enrollment inconsistencies to ensure timely activation.
• Claims & Operational Support: Identify data issues impacting claims adjudication, reimbursement, or provider participation.
• Partner with Claims Operations to resolve discrepancies and support root‑cause analysis.
• Reporting & Analytics: Generate dashboards, productivity logs, discrepancy reports, and data quality metrics.
• Track turnaround times, accuracy rates, and productivity; provide insights to leadership for continuous improvement.
• Provider & Stakeholder Communication: Communicate data requirements, corrections, and discrepancies to credentialing, enrollment, and provider relations teams.
• Maintain clear documentation supporting provider updates and operational workflows.
• Process Improvement & Tooling: Recommend workflow enhancements, automation opportunities, and system updates.
• Support implementation of new tools, templates, and operational processes.

Skills

Collaboration

Customer Problem Solving

Customer Service

Microsoft Applications

Multitasking

Education

Bachelor’s degree preferred.

Job description

General Dynamics Information Technology, Inc. is seeking a Provider Data Representative to ensure complete, accurate provider demographic, participation, credentialing, enrollment, roster, and directory data across WTCHP systems.

The role partners with Provider Relations, Credentialing, Provider Data, Claims Operations, and Contracting to maintain data integrity and support timely claims processing. You will drive data quality, support audits, and generate reports for leadership, while helping