Credentialing Specialist

IVX Health; Brentwood (TN); On-site; USD 20,000 - 26,000; Full time

Benefits offered by this job

Comprehensive Healthcare

401(k) Retirement Plan

Flexible Savings Options

Education Assistance

Job summary

IVX Health is looking for a Credentialing Specialist based in Brentwood, Tennessee. The role focuses on credentialing and enrollment of practitioners for various states. Responsibilities include maintaining provider files, credentialing new hires, and ensuring compliance with federal and state regulations.

Candidates should have a Bachelor’s degree or equivalent experience and 3-5 years in the credentialing field. Proficiency in standard office software and strong analytical skills are vital for success in this role, as is communication with various payers.

Qualifications

• Experience in credentialing with commercial and government payers.
• Certified Provider Credentialing Specialist (CPCS) certification preferred.
• Experience with multi-site and/or multi-state providers.

Responsibilities

• Maintain provider files for credentialing applications.
• Credential new providers and re-credential existing ones.
• Track enrollment status with agencies and payers.

Skills

Exceptional written and verbal communication skills

Strong analytical and problem-solving skills

Knowledge of provider credentialing

Proficiency with standard office software

Education

Bachelor’s degree or equivalent work experience

3-5 years of experience in credentialing

Job description

About the Role

The Credentialing Specialist is responsible for credentialing, enrollment of practitioners reporting for all states and jurisdictions that IVX Health operates. The Credentialing Specialist prepares, tracks, and submits licensure, certification, and credentialing applications to various government and commercial payor offices. The Credentialing Specialist maintains active status for all providers by successfully completing initial and subsequent credentialing packages as required by commercial payers, Medicare, and Medicaid.

Responsibilities

• Maintain individual provider files with up-to-date information necessary for government and commercial payer credentialing applications.
• Credential new providers and re-credential current providers with clinics where they hold staff privileges.
• Facilitate the completion of all payer practitioner linking applications.
• Manage and maintain contracts, licenses, and credentials for all current providers.
• Communicate regularly with payers, including receiving quarterly fee schedules, updates, and other relevant documentation.
• Develop, implement, and monitor processes and procedures to ensure the consistent delivery of quality contracting and credentialing services in an efficient and cost-effective manner.
• Ensure credentialing program compliance with health plans and State/Federal regulations including Medicare, Joint Commission, IMQ, AAAHC, and other accrediting bodies.
• Track enrollment status with each required organization, agency, affiliate, and third-party payer.
• Maintain accurate provider profiles on CAQH, PECOS, and CMS databases.
• Maintain databases for all active provider files, including Verity and Availity.

Essential Competencies

• Exceptional written and verbal communication skills, interacting effectively with internal and external constituents.
• Strong analytical and problem-solving skills.
• Ability to recognize and resolve ambiguous or conflicting objectives.
• Knowledge of provider credentialing and its impact on the practice's revenue cycle.
• Proficiency with standard office software (Microsoft Office, Outlook, Teams, etc.).

Required Education & Experience

• Bachelor’s degree or equivalent work experience.
• 3‑5 years of experience and demonstrated success in provider and facility contracting and credentialing with commercial and government payers.
• Certified Provider Credentialing Specialist (CPCS) certification preferred.
• Demonstrated experience working with multi‑site and/or multi‑state providers.
• Experience with Infusion, G/I, Rheum, Neuro and/or large distributed medical practices desired.

Pay

Pay is based on factors such as market location, job-related knowledge, skills, and experience, and is benchmarked against similar organizations. Compensation decisions depend on facts and circumstances of each case. In addition to cash pay, full-time regular employees are eligible for 401(k), health benefits, and other company-provided benefits. Credentialing Specialist pay range: $20 USD - $26 USD.

About IVX Health

IVX Health is a national provider of infusion and injection therapy for individuals managing chronic conditions such as Rheumatoid Arthritis, Crohn's Disease, and Multiple Sclerosis. We transform the way care is delivered with a focus on patient comfort and convenience, and we empower our team to thrive while living our core values.

Mission

To improve the lives of those we care for by redefining the care experience.

Vision

To be the nation’s preferred destination for pharmaceutical care of complex chronic conditions.

Commitment

To deliver an unmatched care experience with a foundation in world class service and clinical excellence.

Benefits We Offer

• Comprehensive Healthcare – Medical, dental, and vision coverage, including prescription drug plans and telemedicine services.
• Flexible Savings Options – Health Savings Accounts (HSA) and Health Reimbursement Arrangements (HRA).
• Supplemental Protection – Accident, critical illness, and hospital indemnity plans.
• Dependent Care FSA – Pre-tax savings for eligible childcare and dependent care expenses.
• 401(k) Retirement Plan – Competitive company match.
• Disability Coverage – Voluntary short-term and long-term disability plans.
• Fertility and Family Support – Resources and benefits for fertility care and family planning.
• Life and AD&D Insurance – Financial protection for you and your loved ones.
• Counseling and Wellness Support – Free resources for emotional, physical, and financial well-being.
• Education Assistance – Tuition reimbursement and certification support.
• Continuing Education – Access to a CEU library.
• Charitable Giving and Volunteer Program – Matched donations and paid volunteer time off.
• Employee Referral Bonus – Earn rewards for helping us find top talent.

Benefits may vary by employment type. Contact HR for details on eligibility and coverage.

EEO Statement

IVX Health is proud to be an Equal Opportunity Employer. We value diversity and are committed to creating an inclusive environment for all employees. IVX Health wants to have the best available people in every job, and we make employment decisions on the basis of business needs, job requirements, individual qualifications, and merit. Equal employment opportunities are provided to all employees and applicants for employment without regard to race, color, religion, sex, sexual orientation, gender identity, pregnancy, national origin, military and veteran status, age, physical or mental disability, genetic characteristic, reproductive health decisions, family or parental status, or any other legally protected category in accordance with applicable federal, state, or local laws. IVX Health prohibits discrimination, harassment, or retaliation of any kind based on any of these characteristics. Equal employment opportunity will be extended to all persons in all aspects of the employer-employee relationship and all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation benefits, and separation of employment.