Credentialing Specialist: Provider Credentialing Expert

Remote Jobs; Philadelphia (Philadelphia County); On-site; USD 45,000 - 65,000; Full time

Benefits offered by this job

Full benefits package

Generous PTO and paid holidays

Diversity and inclusion

Job summary

Ivy Health is seeking a Credentialing Specialist in Pennsylvania to help enable people to live their lives to the fullest. You will maintain provider data, process enrollment applications, track licenses, and coordinate with our CVO to submit credentialing requests.

The role requires independence, data research skills, and confidentiality, with CPCS certification preferred but not required. Strong communication with providers and insurers is essential.

Qualifications

• Two years of provider credentialing experience, including outpatient PT/OT/SP/ABA/Pediatric Rehab.
• Knowledge of health plans and state agency requirements for credentialing.
• Experience with NPI/CAQH and data maintenance in online systems.
• Excellent oral communication and strong customer service orientation.
• Ability to research, analyze data, and work with a CVO and external vendors.

Responsibilities

• Maintains current and accurate data for all providers.
• Completes enrollment applications, monitors progress, follows up as needed.
• Maintains licenses, malpractice coverage and required documents.
• Tracks license expirations and renewals to ensure timely updates.
• Audits practice addresses with health plans for accuracy.
• Coordinates with CVO to submit credentialing requests.
• Researches data and communicates findings effectively.
• Keeps confidentiality of provider information and works independently.

Skills

Data analysis

Oral communication

Customer service

Independent worker

NPI/CAQH knowledge

Education

High school diploma or GED

CPCS certification

Tools

Microsoft Outlook

Microsoft Word

Microsoft Excel

Access

Credentialing software

Job description

Ivy Health is seeking a Credentialing Specialist in Pennsylvania to help enable people to live their lives to the fullest. You will maintain provider data, process enrollment applications, track licenses, and coordinate with our CVO to submit credentialing requests.

The role requires independence, data research skills, and confidentiality, with CPCS certification preferred but not required. Strong communication with providers and insurers is essential.