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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