Job Title : Credentialing Specialist
Location : Barnabas Health Corp
Department : Medical Staff
Req# : 0000145791
Status : Full-Time
Shift : Day
Pay Range : $52,666.00 - $72,416.00 Annual
Pay Transparency :
The above reflects the anticipated annual salary range for this position if hired to work in New Jersey.
The compensation offered to the candidate selected for the position will depend on several factors, including the candidate's educational background, skills and professional experience.
Job Overview :
The Credentialing Specialist is accountable for performing duties related to the sending, receiving, processing, and primary source verifying applications for initial and reappointment and their related clinical privileges.
Exemplifies a culture of excellence, effective communication and collaboration, and customer service with central Medical Staff Office (MSO) leadership and staff, internal and external customers, providers, and clinical and administrative leaders within RWJBarnabas Health.
Handles, with discretion, issues that are significant, complex, multidisciplinary, sensitive, and confidential.
Possesses and develops a strong grasp of the medical staff operations and the cultures of each affiliated institution and works to collaborates with local Medical Staff Offices to facilitate timely completion of credentialing processing.
Works to develop an overall singular culture of excellence and efficiency across the enterprise.
Qualifications : Required :
- Associates degree or combination of education and experience deemed equivalent
- Successful completion of all RWJBarnabas Health orientation programs
Preferred :
Two years' prior experience in Medical Staff credentialing preferred.Certified Professional in Medical Staff Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS) preferredKnowledge of credentialing software and associated applications strongly preferred (MDStaff)Excellent interpersonal and communication skillsScheduling Requirements :
Hybrid, with on-site and remote capabilities available.Essential Functions :
Oversees and assists with application management and verification activities, preliminary analysis of application and verification informationAnalyze verification information, to include identifying red flag and / or adverse information and notifying central MSO leadership in accordance with policiesOversee the monitoring of expiring information such as but not limited to DEA, license, professional liability insurance, and specialty board certification status; maintain and update credentials file(s)Management of database entries for accuracy and completenessMaintenance of electronic files as requiredEffective and timely communication with local medical staff officesTimely and accurately prepare credential files for audit and submission to the hospitalsMonitor staff productivity in accordance with standard turn-around-timesMaintain a working knowledge of relevant regulatory standards (i.e., TJC, DNV and NCQA), state and federal requirements, and applicable Medical Staff BylawsAssist with the development and implementation of credentialing and recredentialing workflows to ensure efficient and effective alignment of processesAssist in the development or revision of credentialing related formsParticipation in special project teams as assignedTraining of new staff as assigned - credentialing procedures, software, and workflowsEnforcement of internal procedures and controls and problem resolutionTakes a proactive role in monitoring and assisting in improving team productivityContinually strives to achieve individual, team and departmental goalsAll other duties as assignedOther Duties :
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job.Duties, responsibilities and activities may change at any time with or without notice.
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At RWJBarnabas Health, our market-competitive Total Rewards package provides comprehensive benefits and resources to support our employees physical, emotional, social, and financial health.
Paid Time Off (PTO)Medical and Prescription Drug InsuranceDental and Vision InsuranceRetirement PlansShort & Long Term DisabilityLife & Accidental Death InsuranceTuition ReimbursementHealth Care / Dependent Care Flexible Spending Accounts