Remote Provider Credentialing Coordinator I

Navitus Health Solutions, LLC; Oklahoma City (OK); 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 f

Job summary

Navitus Health Solutions is seeking a Coordinator I, Provider Credentials to join our team in the United States. The role coordinates credentialing for pharmacy providers, ensures compliance with URAC standards, and maintains data in credentialing systems.

You will work with HMS, NCPDP, DEA and state boards, report credential activity, and support pharmacy network strategies while communicating with providers and internal teams.

Qualifications

• High school diploma or equivalent; advanced degree preferred.
• Retail or managed care pharmacy experience desired.
• Experience analyzing medical and/or pharmacy claims or credentials.
• Strong independent work and communication skills.

Responsibilities

• Communicate daily with Navitus providers to obtain and process credentials.
• Ensure credentials are documented in systems and file reviews for compliance.
• Support URAC compliance and update policies to meet new regulations.
• Create reports of credential activity for leadership and committees.
• Monitor credential databases (HMS, NCPDP, DEA, State Boards).
• Assist network team with credentialing and pricing questions.
• Support annual fraud, waste, and abuse attestations.
• Update systems to reflect external database data.
• Assist in network strategy discussions.
• Perform additional duties as assigned.

Skills

Independent worker

Communication skills

Data mining

Analytical skills

Multi-tasking

Provider relations

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 in the United States. The role coordinates credentialing for pharmacy providers, ensures compliance with URAC standards, and maintains data in credentialing systems.

You will work with HMS, NCPDP, DEA and state boards, report credential activity, and support pharmacy network strategies while communicating with providers and internal teams.