Remote Provider Credentialing Coordinator I

Navitus Health Solutions, LLC; Nebraska; À distance; USD 28 000 - 33 000; Plein temps

Avantages offerts par ce poste

Health insurance

Paid time off

Retirement plan with company match

Parental leave

Résumé du poste

Navitus Health Solutions, LLC seeks a Coordinator I, Provider Credentials to join our team. You will facilitate receipt, processing, and evaluation of provider credentials, working with NCPDP, HMS, DEA, and state databases. Reports support VP and Credential Committees as needed.

The role ensures credentialing aligns with Navitus policies and URAC standards, preventing non-qualified pharmacies or providers from processing claims, while communicating effectively with internal and external contacts.

Qualifications

• Experience with pharmacy credentialing and regulatory requirements.
• Ability to analyze credential data and maintain records.
• Strong communication and documentation skills.

Responsabilités

• Daily communication with providers to obtain and review credentials.
• Document credentials in systems and audit for compliance.
• Create credential activity reports for leadership.
• Monitor credential databases (NCPDP, HMS, DEA, State Boards).
• Support enterprise credentialing programs and policy updates.

Connaissances

Credentialing experience

Data analysis

Independent worker

Microsoft Office proficiency

Formation

High school diploma or equivalent

Outils

NCPDP systems

State Board databases

Description du poste

Navitus Health Solutions, LLC seeks a Coordinator I, Provider Credentials to join our team. You will facilitate receipt, processing, and evaluation of provider credentials, working with NCPDP, HMS, DEA, and state databases. Reports support VP and Credential Committees as needed.

The role ensures credentialing aligns with Navitus policies and URAC standards, preventing non-qualified pharmacies or providers from processing claims, while communicating effectively with internal and external contacts.