Provider Credentialing Coordinator (Remote)

Navitus Health Solutions, LLC; Lorida (FL); A distancia; USD 28.000 - 33.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health, Dental, Vision insurance

20 days paid time off

4 weeks paid parental leave

9 paid holidays

401K match up to 5%

Adoption Assistance Program

Flexible Spending Account

Educational Assistance Plan and Pro.

Referral Bonus Program – up to $750!

Descripción de la vacante

Navitus Health Solutions is seeking a Coordinator I, Provider Credentials to join our team. The role focuses on facilitating receipt, processing, and reporting of provider credentials, working with NCPDP, HMS, DEA, and state/federal databases.

You will report to the Manager of Provider Services and help ensure compliant credentialing across the network. The position emphasizes independent work, strong communication with providers, and adherence to Navitus policies.

Formación

• High school or equivalent, advanced degree preferred.
• Retail pharmacy experience or managed care setting desired.
• Experience analyzing medical or pharmacy claims or credentials.
• Ability to work independently with strong communication and multitasking skills.
• Proficiency in Microsoft applications and provider interactions.

Responsabilidades

• Daily communication with Navitus pharmacy providers and vendors to obtain and process credentials.
• Ensure credentials are documented in systems and audited for compliance.
• Support URAC and Navitus policies to maintain a qualified provider network.
• Create reports of credential activity for leadership and committees.
• Monitor credential databases (NCPDP, HMS, OIG, DEA, State Boards).
• Assist in administration of pharmacy programs and pricing questions with providers.
• Support attestations and other compliance reporting as required.
• Update systems to reflect external database data where appropriate.
• Assist leadership in developing network strategies and initiatives.
• Perform other duties as assigned.

Conocimientos

Pharmacy credentialing

Provider relations

Data mining

Microsoft Office

Independent work

Communication skills

Pharmacy claims analysis

Educación

High school or equivalent

Advanced degree preferred

Herramientas

NCPDP

HMS

DEA databases

State Boards of Pharmacy

Descripción del empleo

Navitus Health Solutions is seeking a Coordinator I, Provider Credentials to join our team. The role focuses on facilitating receipt, processing, and reporting of provider credentials, working with NCPDP, HMS, DEA, and state/federal databases.

You will report to the Manager of Provider Services and help ensure compliant credentialing across the network. The position emphasizes independent work, strong communication with providers, and adherence to Navitus policies.