Credentialing Supervisor

Credentialing Supervisor

POSITION SNAPSHOT

Site / Department: Credentialing and Billing Department

Location: 118 Vine Ave Sharon PA 16146

Schedule: Monday – Friday 8:30am – 5:00pm

Employment Status: FULL-TIME

WHY THIS ROLE

The Credentialing Supervisor provides oversight of the credentialing specialists and all aspects of insurance enrollment, credentialing, recredentialing, and privileging processes for PHN providers. This role helps ensure providers are appropriately enrolled, credentialed, appointed, and privileged with health plans, hospitals, and patient care facilities while maintaining accurate provider information and timely license and certification renewals.

WHAT YOU'LL DO

·   Supervise credentialing specialists.

·   Compile and maintain current and accurate data for all providers.

·   Oversee completion of provider credentialing and recredentialing applications; monitor applications and follow up as needed.

·   Ensure copies of current state licenses and DEA certificates are maintained.

·   Stay abreast of current health plan and agency requirements for credentialing providers.

·   Set up and maintain provider information in online credentialing databases and systems.

·   Monitor license and certification expirations for all providers to ensure timely renewals.

·   Ensure practice addresses are current with health plans, agencies, and other entities.

·   Build strong working relationships with provider relations representatives at insurance companies.

·   Review insurance updates and attend meetings with insurance carrier representatives.

·   Review claims rejected due to credentialing issues and work with appropriate companies for resolution.

·   Maintain confidentiality and integrity of all information.

·   Perform other related duties as assigned.

WHAT WE'RE LOOKING FOR

·   High school diploma or equivalent.

·   Three years of relevant credentialing experience.

·   Strong communication and organizational skills.

·   Computer proficiency.

BENEFITS

·   Medical, dental and vision coverage - employee and family plans available; eligible immediately upon start

·   Employer-paid short-term disability

·   Employer-paid life insurance

·   Retirement plan

·   Paid time off

·   8 paid holidays

·   College savings plan

·   Fitness center membership reimbursement

·   IDShield & LegalShield

·   Volunteer Time Off Program

ABOUT PRIMARY HEALTH NETWORK

Primary Health Network is the largest Federally Qualified Health Center (FQHC) in Pennsylvania. Our mission is to provide quality primary care services and access to specialty care for the people in the communities we serve.

Ready to make a difference in your community? Apply today to join the PHN team.

Accessibility Support for Applicants

Primary Health Network is committed to providing equal access to employment opportunities.

If you experience difficulty accessing our careers site or completing an application, or if you require a reasonable accommodation due to a disability, please contact us at recruitment@primary-health.net. Our team will work with you to provide an accessible alternative application process.