Credentialing Specialist - Somerset, NJ

RWJBarnabas Health; West Orange (NJ); Hybrid; USD 50,000 - 65,000; Full time

Job summary

An established industry player is seeking a Credentialing Specialist to enhance their medical staff operations. This role involves managing the credentialing process, ensuring compliance with regulatory standards, and fostering effective communication across teams. The ideal candidate will possess strong interpersonal skills and a background in credentialing within healthcare. Join a forward-thinking organization dedicated to improving community health and providing high-quality patient care. This position offers a hybrid work environment, allowing for both on-site and remote work, making it an excellent opportunity for work-life balance.

Benefits

Paid Time Off (PTO)

Medical Insurance

Dental Insurance

Vision Insurance

Retirement Plans

Tuition Reimbursement

Wellness Programs

Voluntary Benefits

Discounts Through Partners

Qualifications

• Associates degree or equivalent experience required.
• 2+ years in CVO or Medical Staff Services preferred.

Responsibilities

• Manage application verification and credentialing processes.
• Monitor and maintain credential files and compliance.

Skills

Credentialing

Communication Skills

Interpersonal Skills

Database Management

Education

Associate's Degree

Tools

Credentialing Software

Job description

Join to apply for the Credentialing Specialist - Somerset, NJ role at RWJBarnabas Health

2 weeks ago Be among the first 25 applicants

Join to apply for the Credentialing Specialist - Somerset, NJ role at RWJBarnabas Health

Get AI-powered advice on this job and more exclusive features.

Req #: 0000145791

Category: Clerical / Administrative Support

Status: Full-Time

Shift: Day

Facility: RWJBarnabas Health Corporate Services

Department: Medical Staff

Location:

SBC Corporation, 95 Old Short Hills Road, Somerset, NJ 07052

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

• At least two (2) years of experience CVO or Medical Staff Services in an acute healthcare setting, including credentialing and privileging
• Certified Professional in Medical Staff Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS) preferred
• Knowledge of credentialing software and associated applications strongly preferred
• Excellent interpersonal and communication skills
• Ability to work under minimal supervision and to adapt quickly to changes within the environment
  
  

Scheduling 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 information
• Analyze verification information, to include identifying red flag and/or adverse information and notifying central MSO leadership in accordance with policies
• Oversee 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 completeness
• Maintenance of electronic files as required
• Effective and timely communication with local medical staff offices
• Timely and accurately prepare credential files for audit and submission to the hospitals
• Monitor staff productivity in accordance with standard turn-around-times
• Maintain a working knowledge of relevant regulatory standards (i.e., TJC, DNV and NCQA), state and federal requirements, and applicable Medical Staff Bylaws
• Assist with the development and implementation of credentialing and recredentialing workflows to ensure efficient and effective alignment of processes
• Assist in the development or revision of credentialing related forms
• Participation in special project teams as assigned
• Training of new staff as assigned - credentialing procedures, software, and workflows
• Enforcement of internal procedures and controls and problem resolution
• Takes a proactive role in monitoring and assisting in improving team productivity
• Continually strives to achieve individual, team and departmental goals
• All other duties as assigned
  
  

Other 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.

Additional Information

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 Insurance
• Dental and Vision Insurance
• Retirement Plans
• Short & Long Term Disability
• Life & Accidental Death Insurance
• Tuition Reimbursement
• Health Care/Dependent Care Flexible Spending Accounts
• Wellness Programs
• Voluntary Benefits (e.g., Pet Insurance)
• Discounts Through our Partners such as NJ Devils, NJ PAC, Verizon, and more!
  
  

Choosing RWJBarnabas Health!

RWJBarnabas Health is the premier health care destination providing patient-centered,

high-quality academic medicine in a compassionate and equitable manner, while delivering

a best-in-class work experience to every member of the team. We honor and appreciate the privilege of creating and sustaining healthier communities, one person and one community at a time. As the leading academic health system in New Jersey, we advance innovative strategies in high-quality patient care, education, and research to address both the clinical and social determinants of health.

RWJBarnabas Health aims to truly make a unique impact in local communities throughout New Jersey. From vastly improving the health of local residents to creating educational and career opportunities, this combination greatly benefits the state. We understand the growing and evolving needs of residents in New Jersey whether that be enhancing the coordination for treating complex health conditions or improving community health through local programs and education.

Equal Opportunity Employer

RWJBarnabas Health is an Equal Opportunity Employer

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care

Referrals increase your chances of interviewing at RWJBarnabas Health by 2x

Get notified about new Credentialing Specialist jobs in West Orange, NJ.

Fair Lawn, NJ $50,000.00-$65,000.00 2 weeks ago

HSPD-12: Government Badging & Credentialing Specialist (Springfield, NJ - REF1649L)**

HSPD-12: Government Badging & Credentialing Specialist (New York - REF1610Z)**

HSPD-12: Government Badging & Credentialing Specialist (Springfield, NJ -REF1649L)**

MEDICAL STAFF CREDENTIALING SPECIALIST - FULL TIME - DAY

Medical Staff Credentialing Specialist - Full Time - Day

New York, NY $180,000.00-$205,000.00 5 days ago

Credentialing Lead – Delegated Payer Audits

New York, NY $62,000.00-$64,000.00 1 week ago

FIELD ELIGIBILITY VERIFICATION SPECIALIST

New York, NY $81,000.00-$91,000.00 8 months ago

We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.