Credentialing Specialist

• Maintain individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applications
• Credential new providers and re-credential current providers with clinics at which they hold staff privileges
• Responsible for facilitating 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 but not limited to receiving quarterly fee schedules, updates, and any additional relevant documentation
• Develop, implement, and monitor processes and procedures to ensure the consistent delivery of quality contracting and credentialing services in an efficient and cost-effective manner
• Ensure that the credentialing program is compliant with health plans, as well as 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 to include Verity and Availity
• Credential new providers and re-credential current providers with clinics at which they hold staff privileges

• 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
• 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

IVX Health is a national provider of infusion and injection therapy for individuals managing chronic conditions like Rheumatoid Arthritis, Crohn's Disease, and Multiple Sclerosis. We’re transforming the way care is delivered with a focus on patient comfort and convenience. Our commitment to exceptional care extends to our employees as well—we empower our team to thrive while living our core values: Be Kind, Do What’s Right, Never Settle, Make It Happen, and Enjoy the Ride.

IVX Health is proud to be an Equal Opportunity Employer. We value diversity and are committed to creating an inclusive environment for all employees. IVX Health wants to have the best available people in every job, and we make employment decisions on the basis of business needs, job requirements, individual qualifications, and merit. Equal employment opportunities are provided to all employees and applicants for employment without regard to race, color, religion, sex, sexual orientation, gender identity, pregnancy, national origin, military and veteran status, age, physical or mental disability, genetic characteristic, reproductive health decisions, family or parental status, or any other legally protected category in accordance with applicable federal, state, or local laws. IVX Health prohibits discrimination, harassment, or retaliation of any kind based on any of these characteristics. Equal employment opportunity will be extended to all persons in all aspects of the employer-employee relationship and all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation benefits, and separation of employment.

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