Provider Data Steward: Credentialing & Directory Integrity

General Dynamics Information Technology; Falls Church (VA); On-site; USD 55,000 - 85,000; Full time

Job summary

General Dynamics Information Technology in Falls Church, VA, is seeking a Provider Data Representative to maintain accurate provider demographic, enrollment, credentialing, roster, and directory information across systems supporting the WTCHP.

The role ensures data integrity to support accurate claims payment, credentialing compliance, and network participation, partnering with Provider Relations, Credentialing, Provider Data, Claims Operations, and Contracting to keep information complete and

Responsibilities

• Process provider roster submissions and updates.
• Maintain accurate provider demographic, enrollment, and participation records.
• Validate and update NPIs, TINs, specialties, practice locations, EFT details, and affiliations.
• Ensure timely changes supporting accurate claims payment and directory publication.
• Reconcile rosters against credentialing, enrollment, and directory systems.
• Coordinate corrections with Provider Relations, Credentialing, and Provider Data teams.
• Validate provider information for credentialing/recredentialing.
• Identify enrollment and participation discrepancies and resolve them.
• Audit provider records for completeness, accuracy, and compliance.
• Produce data quality reports, discrepancy logs, and audit results.
• Provide insights to leadership to guide operational improvements.
• Communicate data requirements and discrepancies to provider relations teams.
• Support automation opportunities and workflow improvements.

Job description

General Dynamics Information Technology in Falls Church, VA, is seeking a Provider Data Representative to maintain accurate provider demographic, enrollment, credentialing, roster, and directory information across systems supporting the WTCHP.

The role ensures data integrity to support accurate claims payment, credentialing compliance, and network participation, partnering with Provider Relations, Credentialing, Provider Data, Claims Operations, and Contracting to keep information complete and