Position Summary. The Credentialing Representative processes the necessary paperwork with all required entities to ensure correct credentialing and billing. Essential Functions. Perform Primary Source verification on all providers utilizing credentialing software. Complete and submit credentialing applications for both providers and. Maintain files with provider and facility. Track information and submit. Completing any re-credentialing applicati...
Under the direct supervision of the Manager of Credentialing, responsible for credentialing of providers and associated activities in support of the credentialing process in accordance with established Health Plan credentialing policies following NCQA, Medicare, the state of West Virginia, West Virginia Medicaid, and the state of Ohio policies and procedures. Required: . High school diploma or equivalent. At least two years related healthcare ex...
