Credentialing Specialist

Ivy Rehab; Oregon; Hybrid; USD 45,000 - 65,000; Full time

Benefits offered by this job

Full benefits within first month

PTO

Paid holidays

Job summary

Ivy Health is seeking a Credentialing Specialist to maintain provider data, enroll providers with payors, and manage licenses and CAQH records. You will coordinate credentialing requests with the CVO and external vendors while ensuring timely renewals and data accuracy.

The role emphasizes independent work, confidentiality, and a strong focus on quality customer service within outpatient rehab networks.

Qualifications

• High school diploma or GED required.
• CPCS certification preferred, but not required.
• Two years of credentialing experience focused on outpatient PT/OT/SP/ABA/Pediatric Rehab.
• Proficient with Outlook, Word, Excel and Access.
• Experience using credentialing software and with a CVO and external vendors.
• Excellent oral communication and phone presence.
• Understanding of quality customer service and relationships with insurers and field operators.

Responsibilities

• Maintains current and accurate data for all providers.
• Completes provider/payor enrollment applications and follows up as needed.
• Keeps copies of licenses, malpractice coverage and required documents.
• Maintains provider information in online databases such as NPI and CAQH.
• Coordinates credentialing requests with the CVO and external vendors.
• Researches and analyzes data; tracks license and certification expirations.
• Audits practice addresses with health plans for accuracy.
• Works independently with minimal supervision and maintains confidentiality.
• Performs other duties as assigned.

Skills

Independent work

Data research

Customer service orientation

Attention to detail

Education

High School diploma / GED

Two years credentialing experience

CPCS certification (preferred)

Tools

CAQH

Microsoft Outlook

Microsoft Word

Microsoft Excel

Microsoft Access

Credentialing software

Job description

State of Location: PennsylvaniaPosition Summary: At Ivy Health, we're "All About the People"! As a Credentialing Specialist, you will play a crucial role in our mission to help enable people to live their lives to the fullest.

Job Description:

Your responsibilities will include:

• Maintains current and accurate data for all providers.
• Completes provider/payor enrollment applications, monitors applications and follow up as needed.
• Maintains copies of current state licenses, malpractice coverage and any other documents required for all providers.
• Must have knowledge of health plans and other state agency requirements for credentialing.
• Maintains provider information in online databases, such as NPI and CAQH.
• Collects information from providers and coordinates with our CVO to submit credentialing requests.
• Ability to research and analyze data.
• Tracks licenses and certification expirations to ensure timely renewals.
• Audits and ensures practice address information with health plans are listed correctly.
• Ability to work independently with minimal supervision.
• Maintains confidentiality of provider information.
• Performs other duties as assigned.

To excel in this role, you should possess:

• A high school diploma or GED equivalent is required.
• Certified Provider Credentialing Specialists (CPCS) certification preferred, but not required.
• A minimum of two years of experience in all facets of provider healthcare credentialing- with a focus on Outpatient PT/OT/SP/ABA/Pediatric Rehab
• Computer skills using Microsoft Outlook, Word, Excel and Access
• Experience using credentialing software and working with a CVO and external vendors.
• Excellent oral communication skills and phone presence
• Understanding of quality customer service and relationship with insurance carriers and field operators.

Why choose Ivy Health?

• Exceeding Expectations: Deliver best-in-class care and witness exceptional patient outcomes.
• Incentives Galore: Eligibility for full benefits package beginning within your first month of employment. Generous PTO (Paid Time Off) plans and paid holidays.
• Empowering Values: Live by values that prioritize teamwork, growth, and serving others.

We are an equal opportunity employer, committed to diversity and inclusion in all aspects of the recruiting and employment process. Actual salaries depend on a variety of factors, including experience, specialty, education, and organizational need. Any listed salary range or contractual rate does not include bonuses/incentive, differential pay, or other forms of compensation or benefits.ivyhealth.com