Remote Provider Credentialing Coordinator

Navitus Health Solutions, LLC; Alabama; Remote; USD 28,000 - 33,000; Full time

Benefits offered by this job

Health, Dental, Vision insurance

Paid time off

4 weeks parental leave

9 holidays

401K company match

Adoption Assistance

Flexible Spending Account

Educational Assistance

Professional Membership

Referral Bonus program

Job summary

Navitus Health Solutions, LLC seeks a Coordinator I, Provider Credentials to join our team. You will facilitate receipt, processing, first-level evaluation, and reporting of provider credentials, working with NCPDP, HMS, DEA, and state/federal databases.

You will report to the Manager of Provider Services and support credentialing across Navitus policies and URAC standards. Responsibilities include auditing credential files, generating credential activity reports, and ensuring timely updates

Qualifications

• High school diploma or equivalent required; advanced degree preferred.
• Retail pharmacy or managed care experience desired.
• Experience analyzing medical/pharmacy claims or credentials is highly desired.

Responsibilities

• Daily communication with Navitus pharmacy providers to obtain, review, and process credentials.
• Ensure credentials are documented in systems and retained in files; audit for non-compliance.
• Support URAC and Navitus policies to maintain a qualified pharmacy network.

Skills

Independent worker

Telephonic communication

Written communication

Data mining

Analytical skills

Provider interaction

Microsoft applications

Education

High school or equivalent

Advanced degree preferred

Tools

Microsoft Office

Job description

Navitus Health Solutions, LLC seeks a Coordinator I, Provider Credentials to join our team. You will facilitate receipt, processing, first-level evaluation, and reporting of provider credentials, working with NCPDP, HMS, DEA, and state/federal databases.

You will report to the Manager of Provider Services and support credentialing across Navitus policies and URAC standards. Responsibilities include auditing credential files, generating credential activity reports, and ensuring timely updates