Provider Credentials Coordinator

Job Summary

To support pharmacy relations, the full-time remote Provider Credentials Coordinator will facilitate the receipt and processing of provider credentials, ensure compliance with federal and state regulations, and create internal and external reports.

Key responsibilities

• Communicate daily with pharmacy providers to obtain, review, and process credentials
• Document and audit pharmacy credentials to ensure compliance with URAC and company policies
• Create and submit reports on credential activity to department leadership and Credential Committees

Required qualifications

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