Provider Credentialing Specialist | Drive Quality Care

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

Job summary

Ivy Health is seeking a Credentialing Specialist in New Jersey to maintain provider data, process enrollment applications, and coordinate with the CVO to ensure timely credentialing. The role requires attention to detail, data analysis, and strong communication with providers and health plans.

Eligible candidates should have at least two years in provider credentialing, proficiency with Microsoft Office, and familiarity with credentialing software.

Qualifications

• High school diploma or GED required.
• CPCS certification preferred.
• Minimum two years of experience in provider healthcare credentialing with focus on outpatient PT/OT/SP/ABA/Pediatric Rehab.
• Proficient with Outlook, Word, Excel and Access.
• Experience using credentialing software with a CVO and external vendors.
• Excellent oral communication and phone presence.
• Understanding of quality customer service and insurance carrier relationships.

Responsibilities

• Maintains current and accurate data for all providers.
• Completes provider/payor enrollment applications and follows up as needed.
• Maintains copies of licenses, malpractice coverage, and required documents for providers.
• Knowledge of health plans and credentialing requirements.
• Maintains provider information in online databases (NPI, CAQH).
• Collects information from providers and coordinates with a CVO to submit credentialing requests.
• Researches and analyzes data.
• Tracks license and certification expirations for renewals.
• Audits and ensures practice address information is listed correctly with health plans.
• Works independently with minimal supervision.
• Maintains confidentiality of provider information.
• Performs other duties as assigned.

Skills

Data analysis

Oral communication

Customer service

Credentialing software experience

Education

High school diploma or GED

CPCS certification

Tools

Microsoft Outlook

Microsoft Word

Microsoft Excel

Microsoft Access

Credentialing software

Job description

Ivy Health is seeking a Credentialing Specialist in New Jersey to maintain provider data, process enrollment applications, and coordinate with the CVO to ensure timely credentialing. The role requires attention to detail, data analysis, and strong communication with providers and health plans.

Eligible candidates should have at least two years in provider credentialing, proficiency with Microsoft Office, and familiarity with credentialing software.