Credentialing Specialist
New
I
IVX HealthHealthcare
Remote - USFull-TimeMiddle
Salary20 - 26 USD per hour
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Job Details
- Experience
- 3-5 years
- Required Skills
- Microsoft Office
Requirements
- Bachelors degree or equivalent work experience
- 3-5 years of experience in provider and facility contracting and credentialing
- Experience with commercial and government payers
- Demonstrated experience in working with multi-site and/or multi-state providers
- Proficiency with standard office software applications (Microsoft Office, Outlook, Teams, etc.)
- Exceptional written and verbal communication skills
- Strong analytical and problem-solving skills
- Certified Provider Credentialing Specialist (CPCS) certification (preferred)
- Experience with Infusion, G/I, Rheum, or Neuro medical practices (desired)
Responsibilities
- Maintain individual provider files for credentialing applications
- Credential new providers and re-credential current providers
- Facilitate completion of payer practitioner linking applications
- Manage contracts, licenses, and credentials for all providers
- Communicate with payers regarding fee schedules and updates
- Develop and monitor processes for quality contracting and credentialing
- Ensure compliance with health plans and State/Federal regulations
- Track enrollment status with agencies and third-party payers
- Maintain provider profiles in CAQH, PECOS, and CMS databases
- Maintain databases including Verity and Availity
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