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Front Desk / Clerical

Specialty/Qualification

Office / Front Desk

Region

Northeast

Location

Rutherford, NJ

What To Know

Work / Life Balance
Urban - Smaller Center
Excellent Schools
Small-Mid Practice / Organization
Competitive Salary

Job ID#

4231

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