Strategic Medical Credentialing Specialist

RWJBarnabas Health; New Jersey; On-site; USD 53,000 - 79,000; Full time

Job summary

SBC Corporation seeks a Credentialing Specialist to perform primary source verification and credentialing for physicians, APPs, and allied professionals, ensuring compliance with accreditation standards and regulatory requirements.

Working within the Credentials Verification Organization (CVO), you will manage credentialing files from intake to completion, ensuring accurate verification to support medical staff appointment, privileging, payor enrollment, and network participation across the

Qualifications

• Associates degree required or a combination of equivalent education, training and experience may be considered.
• Bachelor's degree in healthcare administration or related field preferred.

Responsibilities

• Perform primary source verification of licensure, education, training, board certification, work history, malpractice coverage, sanctions, and other credentialing elements.
• Coordinate application management and verification activities, and preliminary analysis of application and verification information.
• Analyze verification information and identify red flags or adverse information per policy.
• Maintain knowledge of healthcare accreditation and regulatory standards (Joint Commission, DNV, NCQA, CMS).
• Manage database entries for accuracy and completeness and generate credentialing status reports.
• Monitor expiring credentials and coordinate renewal activities.
• Serve as a resource to practitioners, medical staff professionals, payor representatives, and internal stakeholders.
• Collaborate with local Medical Staff Offices, Provider Enrollment, Human Resources, Compliance, and leadership.
• Support onboarding and credentialing timeliness; participate in project teams as assigned.

Education

Associates degree

Bachelor's degree in healthcare administration or related field

Job description

SBC Corporation seeks a Credentialing Specialist to perform primary source verification and credentialing for physicians, APPs, and allied professionals, ensuring compliance with accreditation standards and regulatory requirements.

Working within the Credentials Verification Organization (CVO), you will manage credentialing files from intake to completion, ensuring accurate verification to support medical staff appointment, privileging, payor enrollment, and network participation across the