Remote Provider Credentialing Coordinator I

Navitus; Sacramento (CA); Remote; USD 42,000 - 64,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Paid time off

Parental leave

Holidays

401K match

Adoption assistance

FSAs

Education assistance

Professional memberships

Referral bonus

Job summary

Navitus Health Solutions seeks a Coordinator I, Provider Credentials to efficiently process and credential providers, working with NCPDP, HMS, DEA, and state boards. This role reports to the Manager of Provider Services and supports credentialing accuracy and regulatory compliance.

The ideal candidate will have strong verbal and written communication, attention to detail, and the ability to manage multiple databases and priorities, ensuring timely credentialing while upholding Navitus policies.

Qualifications

• High school diploma or equivalent; advanced degree preferred.
• Experience in retail or managed care pharmacy settings is desirable.
• Experience analyzing medical/pharmacy claims or credentials is highly desirable.
• Ability to work independently and manage multiple priorities with strong communication skills.
• Proficiency with Microsoft applications and data systems.

Responsibilities

• Facilitate receipt, processing, first level evaluation of provider credentials.
• Maintain credentials in systems and ensure documentation compliance.
• Create credential reports and monitor databases (NCPDP, HMS, OIG, DEA, State Boards).
• Support compliance with URAC standards and Navitus policies.
• Collaborate with providers and internal teams to resolve credentialing issues.
• Assist in annual attestations and reflect data changes in external databases.

Skills

Interpersonal skills

Independent work

Communication skills

Data mining

Privacy & compliance

Microsoft Office

Education

High school diploma or equivalent

Advanced degree preferred

Tools

Microsoft Office

Job description

Navitus Health Solutions seeks a Coordinator I, Provider Credentials to efficiently process and credential providers, working with NCPDP, HMS, DEA, and state boards. This role reports to the Manager of Provider Services and supports credentialing accuracy and regulatory compliance.

The ideal candidate will have strong verbal and written communication, attention to detail, and the ability to manage multiple databases and priorities, ensuring timely credentialing while upholding Navitus policies.