Credentialing Specialist

Job not on LinkedIn

🔥 10 minutes ago

🇺🇸 United States – Remote

💵 $20 - $26 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 0%

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IVX Health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2013

🏥 Healthcare

💊 Pharmaceuticals

👥 B2C

Healthcare • Pharmaceuticals • B2C

IVX Health is a national network of outpatient infusion centers that provides biologic infusion and injection therapies for patients with complex chronic conditions such as Crohn’s disease, multiple sclerosis, rheumatoid arthritis, psoriasis, lupus, and severe asthma. The company emphasizes patient comfort and convenience with private suites, flexible scheduling including evenings and weekends, in-network insurance options, and high-quality care delivered by ARNPs, RNs, and medical directors across multiple U. S. locations.

📋 Description

• Maintain individual provider files with up-to-date information for governmental and commercial payer credentialing applications • Credential new providers and re-credential current providers with clinics where they hold staff privileges • Facilitate completion of payer practitioner linking applications • Manage and maintain contracts, licenses, and credentials for current providers • Communicate regularly with payers regarding fee schedules, updates, and relevant documentation • Develop, implement, and monitor processes and procedures for quality, efficient, and cost-effective contracting and credentialing services • Ensure the credentialing program complies with health plans, State and Federal regulations, Medicare, Joint Commission, IMQ, AAAHC, and other accrediting bodies • Track enrollment status with organizations, agencies, affiliates, and third-party payers • Maintain accurate provider profiles on CAQH, PECOS, and CMS databases • Maintain databases for active provider files, including Verity and Availity

🎯 Requirements

• Bachelors degree or equivalent work experience • 3-5 years experience and demonstrated success in provider and facility contracting and credentialing with commercial and government payers • Certified Provider Credentialing Specialist (CPCS) certification preferred • Demonstrated experience in working with multi-site and/or multi-state providers • Experience with Infusion, G/I, Rheum, Neuro and/or large distributed medical practices desired • Exceptional written and verbal communication skills, with a proven ability to interact effectively with a variety of external and internal constituents • Strong analytical and problem-solving skills • Ability to recognize and resolve ambiguous or conflicting objectives • Knowledge of provider credentialing and its direct impact on the practices revenue cycle • Proficiency with standard office software applications (Microsoft Office, Outlook, Teams, etc.)

🏖️ Benefits

• 401(k), health benefits, and other company-provided benefits • Medical, Dental, and Vision Coverage • Prescription Drug Coverage and Telemedicine Services • Health Savings Account (HSA), Health Reimbursement Arrangement (HRA), and Flexible Spending Options • 401(k) Retirement Plan with Company Match • Life, AD&D, and Disability Insurance • Accident, Critical Illness, and Hospital Indemnity Coverage • Fertility and Family Planning Support • Tuition Reimbursement and Certification Assistance • Continuing Education and Professional Development Resources • Employee Assistance Program and Wellness Support • Paid Time Off • Volunteer Time Off and Charitable Giving Match • Employee Referral Bonus Program