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Credentialing Specialist

52 minutes ago
United States
Full-time
Mid Level
Operations Specialist
Operations
Apply Now
IVX Health

IVX Health

IVX Health is a national provider of infusion and injection therapy for patients with complex chronic conditions. They offer biologic infusion and injection therapies in outpatient centers with unique amenities like private suites and flexible scheduli...

Health Care Providers & Services
51-250
Founded 2013
$136M raised
View All Jobs 7

Description

  • Maintain provider files with current information needed 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 to obtain fee schedules, updates, and supporting documentation.
  • Develop, implement, and monitor processes to ensure efficient and cost-effective credentialing and contracting services.
  • Ensure credentialing program compliance with health plans, State and Federal regulations, and accrediting bodies such as Medicare, Joint Commission, IMQ, and AAAHC.
  • Track enrollment status with organizations, agencies, affiliates, and third-party payers.
  • Maintain accurate provider profiles in CAQH, PECOS, and CMS databases.
  • Maintain active provider file databases, including Verity and Availity.

Requirements

  • Bachelor's degree or equivalent work experience.
  • 3-5 years of experience with provider and facility contracting and credentialing for commercial and government payers.
  • Demonstrated success working with multi-site and/or multi-state providers.
  • Strong written and verbal communication skills with the ability to interact effectively with internal and external stakeholders.
  • Strong analytical and problem-solving skills.
  • Ability to recognize and resolve ambiguous or conflicting objectives.
  • Knowledge of provider credentialing and its impact on the revenue cycle.
  • Proficiency with standard office software such as Microsoft Office, Outlook, and Teams.
  • Certified Provider Credentialing Specialist (CPCS) certification preferred.
  • Experience with infusion, gastroenterology, rheumatology, neurology, or large distributed medical practices desired.

Benefits

  • Pay range of $20 to $26 USD per hour.
  • Full-time employees are eligible for 401(k) and health benefits.
  • Comprehensive medical, dental, and vision coverage, including prescription drug plans and telemedicine services.
  • Health Savings Account (HSA) and Health Reimbursement Arrangement (HRA) options.
  • 401(k) retirement plan with a competitive company match.
  • Counseling and wellness support resources.
  • Education assistance, including tuition reimbursement and certification support.
  • Continuing education access through a CEU library.
  • Paid volunteer time off and matched charitable donations.
  • Employee referral bonus.
  • Benefits such as disability coverage, fertility and family support, life and AD&D insurance, and supplemental protection plans.

Interested in this position?

Apply directly on the company website

Apply Now

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