Credentialing Specialist: Streamline Provider Enrollments

ivyrehab; Whippany (NJ); On-site; USD 30,000 - 34,000; Full time

Benefits offered by this job

Medical insurance

Dental & Vision insurance

401k with company matching

Paid PTO and holidays

Life insurance

Pet insurance discounts

Parental leave

Wellness discounts

Job summary

Ivy Health in New Jersey is seeking a Credentialing Specialist to maintain accurate provider data and manage enrollment applications with state agencies and health plans.

You will coordinate with a CVO, track license expirations, and ensure documentation is complete while working independently. A high school diploma is required; CPCS is preferred, and at least two years in provider credentialing focusing on outpatient rehab areas.

Qualifications

• High School diploma or GED is required.
• CPCS certification is preferred but not required.
• Minimum two years of experience in provider healthcare credentialing with focus on outpatient PT/OT/SP/ABA/Pediatric Rehab.
• Proficient in Outlook, Word, Excel and Access.
• Experience with credentialing software and working with a CVO and external vendors.
• Excellent oral communication and customer service skills.

Responsibilities

• 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.

Skills

Oral communication

Independent work

Confidentiality

Data analysis

Education

High School diploma or GED

CPCS certification preferred

Tools

Microsoft Outlook

Microsoft Word

Microsoft Excel

Microsoft Access

Credentialing software

Job description

Ivy Health in New Jersey is seeking a Credentialing Specialist to maintain accurate provider data and manage enrollment applications with state agencies and health plans.

You will coordinate with a CVO, track license expirations, and ensure documentation is complete while working independently. A high school diploma is required; CPCS is preferred, and at least two years in provider credentialing focusing on outpatient rehab areas.