Provider Credentialing Coordinator

Job Summary

To support pharmacy provider credentialing processes, the full-time remote Provider Credentialing Coordinator will manage the receipt, processing, and evaluation of provider credentials while ensuring compliance with federal and state regulations.

Key responsibilities

• Communicate daily with pharmacy providers to obtain and process credentials
• Document and audit pharmacy credentials in compliance with URAC standards and internal policies
• Create and submit reports on credential activities to department leadership and Credential Committees

Required qualifications

• High school diploma or equivalent; advanced degree preferred
• Experience in retail pharmacy or managed care pharmacy settings is desired
• Prior experience analyzing medical and/or pharmacy claims or credentials is highly preferred
• Proficiency in Microsoft applications and ability to manage multiple priorities
• Strong telephonic and written communication skills for professional interactions with providers