Remote Provider Credentials Coordinator

Navitus; Atlanta (GA); Remote; USD 40,000 - 62,000; Full time

Job summary

Navitus Health Solutions in Atlanta, GA is seeking a Coordinator I, Provider Credentials to support credentialing of pharmacy providers. The role involves processing credentialing data, performing first-level evaluations, and creating internal and external reports in collaboration with the Pharmacy Relations team.

You'll work with NCPDP, HMS, DEA, and state boards, ensuring compliance with URAC standards and Navitus policies while maintaining accurate records and supporting related program

Qualifications

• High school diploma or equivalent; advanced degree preferred.
• Retail pharmacy or managed care experience preferred.
• Experience analyzing medical/pharmacy claims or credentials is highly desired.
• Ability to work independently with strong communication and data skills.
• Proficiency in Microsoft Office applications.

Responsibilities

• Communicate daily with Navitus pharmacy providers to obtain and process credentials.
• Audit and maintain credential documentation in systems and files.
• Ensure URAC compliance and Navitus policies; update procedures as needed.
• Create credential activity reports for leadership and committees.
• Monitor credential databases (NCPDP, HMS, OIG, DEA, Boards) for data.
• Support network program administration and pricing questions.
• Assist with attestations and other required attestations.
• Update systems to reflect external databases.
• Assist in network strategy reviews and implementations.
• Perform other duties as assigned.

Skills

Communication skills

Analytical thinking

Data mining

Time management

Provider interaction

Education

High school diploma or equivalent

Associate degree or higher preferred

Tools

Microsoft Office

NCPDP systems

HMS

DEA databases

Job description

Navitus Health Solutions in Atlanta, GA is seeking a Coordinator I, Provider Credentials to support credentialing of pharmacy providers. The role involves processing credentialing data, performing first-level evaluations, and creating internal and external reports in collaboration with the Pharmacy Relations team.

You'll work with NCPDP, HMS, DEA, and state boards, ensuring compliance with URAC standards and Navitus policies while maintaining accurate records and supporting related program