Credentialing Specialist

IVX Health

. Maintain individual provider files with up-to-date information for governmental and commercial payer credentialing applications .

Posted 9/17/2026full-timeRemote • United StatesMid-LevelSenior💰 $20 - $26 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in provider credentialing and contracting processes, ensuring compliance with health plans and regulatory standards. Proficient in managing provider files and maintaining accurate databases to support efficient credentialing services.

Highest-signal resume keywords

Provider CredentialingContract ManagementCPCS CertificationRegulatory ComplianceAnalytical Problem-Solving

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Provider CredentialingContract ManagementRegulatory ComplianceAnalytical SkillsRevenue Cycle Knowledge

Soft Skills

Exceptional Communication SkillsProblem-Solving Skills

Tools & Technologies

Microsoft OfficeOutlookTeamsCAQHPECOSCMSVerityAvaility

Certifications & Qualifications

CPCS Certification

Industry Keywords

Government Payer CredentialingCommercial Payer CredentialingMulti-Site ProvidersMulti-State ProvidersAccrediting Bodies

About the role

Key responsibilities & impact

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

What you’ll need

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

Comp & perks

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