Credentialing Specialist

Mountain State Oral & Facial Surgery•Hurricane, WV

1d•Onsite

About The Position

Our company has been a prominent provider specializing in oral and maxillofacial surgery throughout the state of West Virginia for over 25 years with recent expansion into the Kentucky and Virginia regions. Our mission is to provide an excellent and optimal patient experience in our state-of-the-art facilities. Our skilled surgeons utilize advanced oral and facial surgical techniques to deliver exceptional care. As an employer, we are focused on always striving to create a best-in-class experience for the entirety of our employees’ career from application to retirement. We seek team-oriented individuals with a desire to grow and develop within our progressing organization.

Requirements

Knowledge of provider credentialing
Excellent computer skills including Excel, Word, and Internet use
Excellent verbal and written communication skills
Excellent interpersonal skills
Must be detail-oriented with excellent organizational skills
Plans and prioritizes to meet deadlines
Ability to function in fast paced and/or stressful work environment
Must adhere to company policies and procedure
High School Diploma or equivalent required
5 years of credentialing experience required

Nice To Haves

5 years Microsoft Office experience preferred
5 years knowledge of AAAHC, NCQA, and TDI preferred

Responsibilities

Maintain individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applications
Maintain internal provider grid to ensure all information is accurate and logins are available
Apply for and renew annually all provider licenses; Professional, DEA, Controlled Substance, etc.
Complete revalidation requests issued by government payers
Complete credentialing applications to add providers to commercial payers, Medicare, and Medicaid, hospitals
Complete re-credentialing applications for commercial payers and hospitals
Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases
Other duties as assigned