Credentialing Specialist

ivyhealth; Philadelphia (Philadelphia County); Hybrid; USD 52,000 - 68,000; Full time

Benefits offered by this job

Full benefits package

Paid Time Off (PTO)

Paid holidays

Professional development opportunities

Job summary

Ivy Health, Pennsylvania, is seeking a Credentialing Specialist to maintain provider data, process enrollment applications, and coordinate with a CVO to ensure timely credentialing.

The role requires a high school diploma or GED, 2+ years in provider credentialing (Outpatient PT/OT/SP/ABA/Pediatric Rehab), and proficiency with MS Office and credentialing software; CPCS preferred but not required. Ivy Health offers benefits and PTO.

Qualifications

• High school diploma or GED required.
• Minimum 2 years in provider credentialing, outpatient PT/OT/SP/ABA/peds rehab.
• CPCS certification preferred but not required.
• Proficient with MS Outlook, Word, Excel and Access.
• Experience with credentialing software and working with a CVO.

Responsibilities

• Maintain current data for all providers.
• Complete provider/enrollment applications and follow up as needed.
• Maintain copies of licenses, malpractice coverage and other required documents.
• Coordinate with CVO and external vendors for credentialing requests.
• Audit practice address information with health plans for accuracy.
• Maintain confidentiality of provider information.
• Perform other duties as assigned.

Skills

Healthcare credentialing

Data research

MS Office

Communication skills

Education

High school diploma or GED

Tools

Credentialing software

CVO coordination

External vendors

Job description

State of Location: Pennsylvania Position 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 Welcome to Ivy Health Join us on our mission to inspire & enable people to live life to the fullest! Ivy Health is a growing team of orthopedic and pediatric outpatient physical, occupational, speech, and ABA therapy clinics with over 500 locations throughout the Northeast, Mid-Atlantic, Midwest, and Southeast. Through a shared commitment to clinical excellence, we work as a unified team to serve each person to the best of our ability. Combining our clinical objectives and company culture, you can see why Ivy is committed to providing endless opportunities to every teammate through professional development tracks, continuing education, leadership development, residency cohorts, mentorship programs, and many other resources.