Remote Provider Credentialing Coordinator

Navitus Health Solutions, LLC; Bastrop (LA); Remote; USD 28,000 - 33,000; Full time

Benefits offered by this job

Health Insurance

Dental & Vision Insurance

Paid Time Off

Parental Leave

401K Match

Educational Assistance Plan

Job summary

Navitus Health Solutions is seeking a Coordinator I, Provider Credentials to join our team in a credentialing capacity. You will manage provider credentials, coordinate with databases, and ensure compliance with policies and URAC standards.

The role supports the Pharmacy Relations Contract Analysts and reports to the Manager of Provider Services. Strong communication, independence, and data-mining skills are essential as you work with national provider networks to maintain accurate credential

Qualifications

• Proficient in verbal and written communication.
• Ability to work independently and manage multiple priorities.
• Experience analyzing claims or credentials is highly desired.
• Familiarity with pharmacy processing practices and regulatory concepts.

Responsibilities

• Daily communication with Navitus pharmacy providers and vendors to obtain, review, and process credentials.
• Ensure credentials are documented in systems and retained in files; audit for non-compliant documents.
• Support URAC compliance and policy updates to meet statutes and guidance.
• Create credential activity reports for leadership and committees.
• Monitor credential databases (HMS, NCPDP, OIG, DEA, State Boards).
• Assist in resolving pricing questions and processing requirements with providers.

Skills

Telephonic communication

Written communication

Data mining

Analytical skills

Multitasking

Education

High school diploma

Advanced degree preferred

Tools

Microsoft Office

Job description

Navitus Health Solutions is seeking a Coordinator I, Provider Credentials to join our team in a credentialing capacity. You will manage provider credentials, coordinate with databases, and ensure compliance with policies and URAC standards.

The role supports the Pharmacy Relations Contract Analysts and reports to the Manager of Provider Services. Strong communication, independence, and data-mining skills are essential as you work with national provider networks to maintain accurate credential