Provider Credentialing Specialist - Remote Eligible

Talentify; Whippany (NJ); Remote; USD 30,000 - 34,000; Full time

Benefits offered by this job

Full benefits package within 1 month

Generous PTO and paid holidays

401k with company matching

Dental, vision, life insurance

Pet insurance discounts

Parental leave and maternity leave

Gym and wellness discounts

Mental health and financial services

Job summary

Ivy Health is seeking a Credentialing Specialist to maintain provider data, manage enrollment applications, and ensure compliance with state licenses and health plans. You will coordinate with a CVO and support accuracy across NPI/CAQH databases.

Ideal candidates have at least two years in credentialing, strong Microsoft Office skills, and the ability to work independently while delivering quality service to insurance carriers and field operators. Remote work options are available.

Qualifications

• 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.

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

Phone presence

Customer service

Independent work

Research & data analysis

Education

High school diploma or GED

Tools

Microsoft Outlook

Microsoft Word

Microsoft Excel

Microsoft Access

Credentialing software

CVO coordination

Job description

Ivy Health is seeking a Credentialing Specialist to maintain provider data, manage enrollment applications, and ensure compliance with state licenses and health plans. You will coordinate with a CVO and support accuracy across NPI/CAQH databases.

Ideal candidates have at least two years in credentialing, strong Microsoft Office skills, and the ability to work independently while delivering quality service to insurance carriers and field operators. Remote work options are available.