Credentialing Specialist

State of Location:

Position Summary:

Job Description:

Your responsibilities will include: 

• Maintains current and accurate data for all providers. 

• Completes provider/payor enrollment applications, monitors applications and follow up as needed.

• Maintains copies of current state licenses, malpractice coverage and any other documents required for all providers. 

• Must have knowledge of health plans and other state agency requirements for credentialing. 

• Maintains provider information in online databases, such as NPI and CAQH. 

• Collects information from providers and coordinates with our CVO to submit credentialing requests.

• Ability to research and analyze data. 

• Tracks licenses and certification expirations to ensure timely renewals. 

• Audits and ensures practice address information with health plans are listed correctly. 

• Ability to work independently with minimal supervision. 

• Maintains confidentiality of provider information. 

• Performs other duties as assigned.  

To excel in this role, you should possess: 

• A high school diploma or GED equivalent is required.
• Certified Provider Credentialing Specialists (CPCS) certification preferred, but not required.
• A minimum of two years of experience in all facets of provider healthcare credentialing- with a focus on Outpatient PT/OT/SP/ABA/Pediatric Rehab
• Computer skills using Microsoft Outlook, Word, Excel and Access
• Experience using credentialing software and working with a CVO and external vendors.
• Excellent oral communication skills and phone presence
• Understanding of quality customer service and relationship with insurance carriers and field operators.

Why choose Ivy Health?    

• Exceeding Expectations: Deliver best-in-class care and witness exceptional patient outcomes.    

• Incentives Galore: Eligibility for full benefits package beginning within your first month of employment. Generous PTO (Paid Time Off) plans and paid holidays. 

• Empowering Values: Live by values that prioritize teamwork, growth, and serving others. 

We are an equal opportunity employer, committed to diversity and inclusion in all aspects of the recruiting and employment process. Actual salaries depend on a variety of factors, including experience, specialty, education, and organizational need. Any listed salary range or contractual rate does not include bonuses/incentive, differential pay, or other forms of compensation or benefits.

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