Remote Provider Credentialing Coordinator

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

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Paid time off

Parental leave

Holidays

401K company match

Adoption Assistance Program

Flexible Spending Account

Educational Assistance Plan

Job summary

Navitus Health Solutions, LLC is seeking a Coordinator I, Provider Credentials to join our team and facilitate provider credentialing processes. This role interacts with NCPDP, HMS, DEA, and state databases to ensure compliance and proper enrollment.

The Coordinator I will work under the Manager of Provider Services, ensuring credentialing aligns with Navitus policies and URAC standards while supporting related credentialing reporting and data updates.

Qualifications

• High school or equivalent; advanced degree preferred.
• Retail pharmacy or managed care setting experience desired.
• Experience analyzing medical/pharmacy claims or credentials.
• Independent work ability with strong telephonic and written skills.
• Proficient in Microsoft Office and related tools.

Responsibilities

• Daily communication with providers and vendors to obtain and review credentials.
• Document credentials in systems and retain in contract files.
• Audit files to identify non-compliant documentation.
• Create credential activity reports for leadership and committees.
• Monitor credential databases (NCPDP, HMS, DEA, State Boards).
• Support resolving pricing questions and processing requirements with providers.
• Assist with annual Fraud, Waste, and Abuse attestations.
• Update systems to reflect external database data.
• Support network strategy discussions with VP and teams.
• Perform other duties as assigned.

Skills

Communication skills

Independent worker

Multi-tasking

Telephonic communication

Education

High school diploma or equivalent

Advanced degree preferred

Tools

Microsoft applications

NCPDP databases

Job description

Navitus Health Solutions, LLC is seeking a Coordinator I, Provider Credentials to join our team and facilitate provider credentialing processes. This role interacts with NCPDP, HMS, DEA, and state databases to ensure compliance and proper enrollment.

The Coordinator I will work under the Manager of Provider Services, ensuring credentialing aligns with Navitus policies and URAC standards while supporting related credentialing reporting and data updates.