Remote Provider Credentialing Coordinator

Navitus; Harrisburg (Dauphin County); A distancia; USD 42.000 - 64.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health insurance

Dental insurance

Vision insurance

PTO 20 days

Parental leave

9 paid holidays

401K matching

Adoption assistance

Flexible Spending Account

Educational assistance

Professional membership assistance

Referral bonus

Descripción de la vacante

Navitus Health Solutions is seeking a Coordinator I, Provider Credentials to join our team. The role focuses on processing credentials, maintaining provider databases, and ensuring compliance with URAC standards.

You will generate credential reports, monitor databases like NCPDP, HMS, OIG, and DEA, and support the Pharmacy Relations team with credentialing activities and attestation processes. The position emphasizes independent work, strong communication, and accuracy.

Formación

• Experience in analyzing medical or pharmacy claims or credentials is desirable.
• Knowledge of pharmacy processing practices, laws and regulations is preferred.
• Ability to work independently and communicate effectively across levels.

Responsabilidades

• Facilitate receipt, processing, and first level evaluation of provider credentials.
• Create reports of credential activity and present to VP and Credential Committees.
• Monitor credential databases (NCPDP, HMS, DEA, State Boards) and ensure documentation in systems.
• Support compliance with URAC standards and Navitus policies.

Conocimientos

Telephonic communication

Written communication

Analytical skills

Data mining

Multitasking

Interpersonal with providers

Educación

High school diploma

Bachelor’s degree preferred

Herramientas

Microsoft Office

Descripción del empleo

Navitus Health Solutions is seeking a Coordinator I, Provider Credentials to join our team. The role focuses on processing credentials, maintaining provider databases, and ensuring compliance with URAC standards.

You will generate credential reports, monitor databases like NCPDP, HMS, OIG, and DEA, and support the Pharmacy Relations team with credentialing activities and attestation processes. The position emphasizes independent work, strong communication, and accuracy.