Credentialing Specialist

IVX Health

4h•$20 - $26•Onsite

About The Position

The Credentialing Specialist is responsible for credentialing and enrollment of practitioners across all states and jurisdictions where IVX Health operates. This role involves preparing, tracking, and submitting licensure, certification, and credentialing applications to various government and commercial payor offices. The Credentialing Specialist ensures that all providers maintain active status by successfully completing initial and subsequent credentialing packages as required by commercial payers, Medicare, and Medicaid.

Requirements

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.).
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.
Demonstrated experience in working with multi-site and/or multi-state providers.

Nice To Haves

Certified Provider Credentialing Specialist (CPCS) certification preferred.
Experience with Infusion, G/I, Rheum, Neuro and/or large distributed medical practices desired.

Responsibilities

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 at which they hold staff privileges.
Facilitate the completion of all payer practitioner linking applications.
Manage and maintain contracts, licenses, and credentials for all current providers.
Perform regular communication with payers, including receiving quarterly fee schedules, updates, and other relevant documentation.
Develop, implement, and monitor processes and procedures to ensure consistent delivery of quality contracting and credentialing services efficiently and cost-effectively.
Ensure the credentialing program complies with health plans, State and Federal regulations, including Medicare, Joint Commission, IMQ, AAAHC, and other accrediting bodies.
Track enrollment status with each required organization, agency, affiliate, and third-party payer.
Maintain accurate provider profiles on CAQH, PECOS, and CMS databases.
Maintain databases for all active provider files, including Verity and Availity.

Benefits

401(k) Retirement Plan – Secure your future with a competitive company match.
Comprehensive Healthcare – Medical, dental, and vision coverage, including prescription drug plans and telemedicine services.
Flexible Savings Options – Choose from Health Savings Accounts (HSA) and Health Reimbursement Arrangements (HRA) to manage healthcare costs.
Supplemental Protection – Accident, critical illness, and hospital indemnity plans to provide additional financial security.
Dependent Care FSA – Pre-tax savings for eligible childcare and dependent care expenses.
Disability Coverage – Voluntary short-term and long-term disability plans to protect your income.
Fertility and Family Support – Resources and benefits designed to support fertility care and family planning.
Life and AD&D Insurance – Financial protection for you and your loved ones.
Counseling and Wellness Support – Free resources to support emotional, physical, and financial well-being.
Education Assistance – Tuition reimbursement and certification support to help you grow in your career.
Continuing Education – Access to a CEU library for ongoing professional development.
Charitable Giving and Volunteer Program – Matched donations and paid volunteer time off to support causes you care about.
Employee Referral Bonus – Earn rewards for helping us find top talent.