Credentialing Specialist

Ivy Health Inc; Philadelphia (Philadelphia County); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

Full benefits package

Generous PTO

Paid holidays

Job summary

Ivy Health Inc is seeking a Credentialing Specialist to support credentialing activities for providers, ensuring up-to-date data and regulatory compliance. You will handle enrollment applications, monitor progress, and maintain licensing and credentialing documentation for multiple providers.

The role requires coordination with a CVO, knowledge of health plans, and strong communication skills. Experience in outpatient PT/OT/SP/ABA/Pediatric Rehab is a plus; CPCS certification is preferred but

Qualifications

• High school diploma or GED required.
• Two years of credentialing experience preferred, especially in outpatient rehab.
• CPCS certification preferred but not required.
• Proficient with Microsoft Outlook, Word, Excel and Access.
• Experience with credentialing software and with a CVO/external vendors.
• Excellent oral communication and strong customer service orientation.

Responsibilities

• Maintains current and accurate data for all providers.
• Completes provider/payor enrollment applications and monitors status.
• Maintains copies of state licenses, malpractice coverage and required documents.
• Knowledge of health plans and state credentialing requirements.
• Maintains provider information in NPI/CAQH databases.
• Coordinates with CVO to submit credentialing requests.
• Researches and analyzes data; tracks license/certification expirations.
• Audits practice address information against health plans.
• Works independently with minimal supervision.
• Maintains confidentiality of provider information.

Skills

Credentialing experience

Outpatient rehab knowledge

Microsoft Office

Credentialing software

Communication skills

CVO/vendor coordination

Education

High school diploma or GED

CPCS certification (preferred)

Tools

Outlook

Word

Excel

Access

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