Position : Credentialing Specialist
Location : Onsite : 651 Willow Grove Street, Hackettstown, NJ 07840 OR 99 Beauvoir Avenue, Summit, NJ 07901
Duration : 03+ months contract position with strong possibility of extension
Shift timing : Mon- Fri : 8am - 4pm (7.5 hrs / day & 37.5 hrs / week)
Pay Rate : $40 / hr on W2
JOB ID- 36628669 & 36628943
Locations Available :
36628669- 651 Willow Grove Street, Hackettstown, NJ 07840
36628943- 99 Beauvoir Avenue, Summit, NJ 07901
IF INTERESTED, PLEASE SEND YOUR MOST UPDATED RESUME WITH 2 REFERENCES FROM RECENT OR RECENT PAST EMPLOYMENT!
Notes :
- Verification of Credentials Confirm that healthcare providers (e.g., physicians, nurses, therapists) have valid and current licenses, certifications, education, and training. Verify board certifications, malpractice history, and work experience.
- Compliance and Regulatory Oversight Ensure all providers meet the requirements of regulatory agencies, hospitals, and insurance networks. Maintain compliance with standards from organizations such as The Joint Commission (TJC) or NCQA.
- Enrollment and Privileging Manage applications for providers to be enrolled with insurance payers (so they can bill for services). Handle the hospital privileging process, which authorizes providers to perform specific procedures within a facility.
- Record Maintenance Maintain accurate and up-to-date credential files for each provider. Track expiration dates for licenses, certifications, and re-credentialing timelines.
- Communication and Coordination Act as a
liaison between providers, HR, medical staff offices, and payers. Communicate with state licensing
Essential Functions :
Enforce regulatory compliance and quality assurancePrepare and maintain reports of credentialing activities such as accreditation, membership or facility privilegesEnsure that all information meets legal, federal and state guidelines when processing applicationsResponsible for carrying out various credentialing processes in relation to physicians and allied health practitionersProcess applications for initials applicants as well as reappointments (approximately 125-200 quarterly)Collect and process significant amounts of verification and accreditation information Maintain and update accurate information in the Echo database (includes education, training, experience, licensure)Prepare material for Credentials Committee meeting, MEC as well as Board of Trustees meeting Sets up and maintains provider information in Echo Maintains confidentiality of provider informationEnsure compliance with the Bylaws at each location as it pertains to the credentialing process Schedule, and on occasion attend and take minutes for site based medical staff department meetingsProcess and collect dues for the site based medical staffCompiles and maintains current and accurate data for all providersSets up and maintains provider information in online credentialing databaseTracks license and certification expirations for all providersMaintains confidentiality of provider information All other duties as assignedQualifications :
Knowledge of the credentialing process requiredAbility to organize and prioritize work and manage multiple prioritiesExcellent verbal and written communication skillsAbility to research and analyze dataAbility to work independentlyAbility to establish and maintain effective working relationshipsExcellent computer skills