Credentialing & Privileging Specialist II

Atlantic Health System; Summit (NJ); On-site; USD 80,000 - 110,000; Full time

Benefits offered by this job

Medical, Dental, Vision, Prescription

PTO & Paid Sick Leave

Tuition Assistance

Parental, Adoption, Surrogacy Leave

Backup and On-Site Childcare

Job summary

Atlantic Health System is seeking a credentialing and privileging professional to conduct primary source verifications, resolve discrepancies, and support privilege determinations for medical staff across affiliated hospitals.

The role emphasizes rigorous adherence to Joint Commission, CMS, and NCQA standards, with collaboration among clinical leadership, HR, legal, and external licensing boards to maintain defensible privileging processes and timely activation of privileges.

Qualifications

• Requires experience with credentialing workflows in a hospital or health system.
• Strong knowledge of Joint Commission, CMS, NCQA standards.
• Ability to analyze complex information and manage competing priorities.
• Excellent communication and training skills are essential.

Responsibilities

• Lead comprehensive credentialing and privileging processes from file intake to board action.
• Investigate discrepancies, adverse findings, and ensure regulatory compliance.
• Coordinate with medical staff leadership and committees for reviews and decisions.
• Maintain accurate, audit-ready documentation and system updates.

Skills

Credentialing

Privileging

Regulatory compliance

Communication

Education

Associate's or Bachelor's degree in Business, Finance, Healthcare, or related field

Tools

Credentialing Software (Verity Credential Stream, Echo, MDStaff)

Job description

Atlantic Health System is seeking a credentialing and privileging professional to conduct primary source verifications, resolve discrepancies, and support privilege determinations for medical staff across affiliated hospitals.

The role emphasizes rigorous adherence to Joint Commission, CMS, and NCQA standards, with collaboration among clinical leadership, HR, legal, and external licensing boards to maintain defensible privileging processes and timely activation of privileges.