Remote Provider Credentialing Coordinator

Navitus Health Solutions, LLC; California City (CA); Remote; USD 28,000 - 33,000; Full time

Benefits offered by this job

Health, Dental, and Vision insurance

20 days paid time off

4 weeks paid parental leave

9 paid holidays

401K company match up to 5%

Adoption Assistance Program

Flexible Spending Account

Educational Assistance Plan and Pro/M—

Job summary

Navitus Health Solutions is seeking a Coordinator I, Provider Credentials to join our team. The role focuses on facilitating receipt, processing, first-level evaluation, and reporting of provider credentials across multiple databases and regulatory requirements.

The incumbent will work with NCPDP, HMS, DEA, and state/federal databases, reporting to the Manager of Provider Services. Responsibilities include ensuring compliant credentialing and contributing to program objectives within Navitus’

Qualifications

• High school or equivalent; advanced degree preferred.
• Retail pharmacy experience or managed care setting desired.
• Experience analyzing medical/pharmacy claims or credentials.
• Ability to work independently and manage multiple priorities.
• Strong verbal and written communication with providers at all levels.

Responsibilities

• Daily communication with Navitus pharmacy providers and vendors to obtain, review, and process credentials.
• Ensure credentials are documented in systems and files; audit for compliance.
• Support URAC and Navitus policies; update procedures to reflect new laws/regulations.
• Create credential activity reports for leadership and committees.
• Monitor credential databases (HMS, NCPDP, DEA, State Boards) and extract data as needed.
• Assist in provider network strategy development with leadership.

Skills

Telephonic communication

Written communication

Data mining

Analytical skills

Multitasking

Provider interaction

Independence

Microsoft Office

Education

High school or equivalent

Advanced degree preferred

Tools

Microsoft Office

Job description

Navitus Health Solutions is seeking a Coordinator I, Provider Credentials to join our team. The role focuses on facilitating receipt, processing, first-level evaluation, and reporting of provider credentials across multiple databases and regulatory requirements.

The incumbent will work with NCPDP, HMS, DEA, and state/federal databases, reporting to the Manager of Provider Services. Responsibilities include ensuring compliant credentialing and contributing to program objectives within Navitus’