Remote Provider Credentialing Coordinator

Navitus Health Solutions, LLC; Clayton (NC); A distancia; USD 28.000 - 33.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health Insurance

Dental Insurance

Vision Insurance

Paid Time Off

Parental Leave

9 paid holidays

401K company match

Adoption Assistance

Flexible Spending Account

Educational Assistance Plan

Referral Bonus Program – up to $750

Descripción de la vacante

Navitus Health Solutions, LLC is seeking a Coordinator I, Provider Credentials to join our team. This role manages receipt, processing, and first-level evaluation of provider credentials across state and federal databases, ensuring URAC compliance and qualified networks.

You will partner with Pharmacy Relations, review credential data, generate reports, and support attestations while upholding Navitus’ high standards for service, accuracy, and provider partnerships.

Formación

• High school diploma or equivalent required; advanced degree preferred.
• Experience analyzing medical or pharmacy claims/credentials is desired.
• Ability to work independently and manage multiple priorities.

Responsabilidades

• Daily communication with Navitus pharmacy providers and vendors to obtain and review credentials.
• Ensure credentials are documented and retained in appropriate systems; audit non-compliant files.
• Support URAC compliance and Navitus policies to maintain a qualified provider network.
• Create credential activity reports; monitor data in HMS, NCPDP, OIG, DEA, State Boards.
• Assist in accreditation attestations and update systems to reflect external databases.

Conocimientos

Communication skills

Independent work

Microsoft Office

Data mining

Analytical skills

Educación

High school diploma or equivalent

Advanced degree preferred

Herramientas

Microsoft Office Suite

Descripción del empleo

Navitus Health Solutions, LLC is seeking a Coordinator I, Provider Credentials to join our team. This role manages receipt, processing, and first-level evaluation of provider credentials across state and federal databases, ensuring URAC compliance and qualified networks.

You will partner with Pharmacy Relations, review credential data, generate reports, and support attestations while upholding Navitus’ high standards for service, accuracy, and provider partnerships.