Credentialing Specialist

SpineSearch is seeking to fill an opening for a Credentialing Specialist to join a growing neurosurgery practice based out of Rutherford, New Jersey.

Requirements of the Credentialing Specialist:

• High School Diploma
• CPMSM or CPCS certification preferred
• Must have at least 1 year of experience in medical credentialing

Benefits of the Credentialing Specialist:

• Full time, Monday through Friday
• Competitive salary
• Full suite of benefits

Responsibilities of the Credentialing Specialist:

• Compile and maintain data for all providers
• Complete provider credentialing applications, monitor applications and follow-ups
• Maintain copies of credentialing documents for providers
• Maintain corporate provider contract files
• Sets up and maintains provider information in database
• Handles the licensing & credentialing process for all contracted providers, in accordance with company standards, Federal and State laws.
• Coordinates the management of the licensing & credentialing database and associated modules, ensuring accuracy of data and reporting to downstream systems. Monitors critical data for extensive analysis and report generation.
• Manages key vendor relationships with two licensing partners and one revenue cycle management partner, including daily review of activity and weekly status reports.
• Coordinates the management of the electronic credentials application, to ensure distribution, receipt, processing, and timely delivery to health system clients.
• Coordinates the management of expirable process to ensure all contracted provider licenses and certificates remain current, ensuring appropriate notification prior to expiration.
• Monitors and reports turnaround times for processing of credentials applications, with continued focus on delivery of a high-quality product, with the greatest efficiency, in the least amount of time.
• Provides on-site consultations with regards to credentialing practices and services; prepares and conducts credentialing orientations and provides updates as appropriate on new policies and procedures.
• Prepares for and coordinates credentialing audits as needed
• Functions as primary licensing & credentialing contact for all internal and external inquiries; develops and maintains positive working relationships.
• Performs miscellaneous job-related duties as assigned