Remote Provider Credentials Coordinator

Navitus Health Solutions, LLC; Maryland City (MD); Remote; USD 28,000 - 33,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

PTO 20 days

Parental leave 4 weeks

Holidays 9

401K match 5%

Adoption assistance

FSAs

Education assistance

Professional membership assistance

Referral bonus

Job summary

Navitus Health Solutions is seeking a Coordinator I, Provider Credentials to join our team. The role ensures receipt, processing, and first-level evaluation of provider credentials, working with NCPDP, HMS, DEA, and state/federal databases.

You will report to the Manager of Provider Services and help maintain URAC-compliant credentialing across the pharmacy network. Ideal candidates have strong communication, data-mining, and analytic skills, with the ability to balance multiple priorities and

Qualifications

• Extensive communication with providers via phone and email.
• Analyze medical and/or pharmacy claims or credentials.
• Work independently while coordinating with multiple departments.

Responsibilities

• Daily communication with Navitus pharmacy providers to obtain credentials.
• Audits credential files for compliance and updates systems.
• Creates credential activity reports for leadership.
• Monitors databases such as HMS, NCPDP, DEA and state boards.
• Supports network programs and resolves pricing questions.
• Assists with annual Fraud, Waste and Abuse attestations.
• Updates external databases to reflect current data.
• Assists VP and network development in strategy execution.
• Performs other duties as assigned.

Skills

Telephonic & written communication

Analytical skills

Data mining

Independent work

Provider interaction

Education

High school diploma or equivalent

Advanced degree preferred

Job description

Navitus Health Solutions is seeking a Coordinator I, Provider Credentials to join our team. The role ensures receipt, processing, and first-level evaluation of provider credentials, working with NCPDP, HMS, DEA, and state/federal databases.

You will report to the Manager of Provider Services and help maintain URAC-compliant credentialing across the pharmacy network. Ideal candidates have strong communication, data-mining, and analytic skills, with the ability to balance multiple priorities and