Credentialing Specialist

About This Role

This Credentialing Specialist role at Ivy Health is crucial for enabling people to live their lives to the fullest by maintaining accurate provider data and ensuring smooth credentialing processes. The position involves managing provider information, coordinating with a CVO, and ensuring compliance with health plan requirements.

Responsibilities

• Maintain current and accurate data for all providers
• Complete provider/payor enrollment applications, monitor applications, and follow up as needed
• Maintain copies of current state licenses, malpractice coverage, and any other required documents for all providers
• Maintain provider information in online databases, such as NPI and CAQH
• Collect information from providers and coordinate with the CVO to submit credentialing requests
• Track licenses and certification expirations to ensure timely renewals
• Audit and ensure practice address information with health plans is listed correctly
• Maintain confidentiality of provider information
• Perform other duties as assigned

Requirements

• High school diploma or GED equivalent is required
• 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

Nice to have:

• Certified Provider Credentialing Specialists (CPCS) certification

Benefits

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

About the Company

At Ivy Health, the mission is to help enable people to live their lives to the fullest, prioritizing teamwork, growth, and serving others.