Credentialing Specialist Req #: 0000181440
Category: Clerical / Administrative Support
Status: Full-Time
Shift: Day
Facility: Barnabas Health Medical Group
Department: UPA Administration
Location: Barnabas Health Medical Group, 90 Bergen Street, Newark, NJ 07103

Job Overview:

The Credentialing Specialist provides coordination and completion of credentialing and recredentialing activities for new and participating providers of the Rutgers New Jersey Medical School NJMS in Newark, NJ. This position is responsible for the review and processing of governmental applications, verification of credentials, timely application processing and maintenance of provider credentialing database and related information.

Qualifications:

Required:

High School Diploma or GED equivalent requiredKnowledge and understanding of credentialing processesAbility to organize, prioritize work and manage multiple priorities simultaneouslyExcellent verbal and written communication skillsExcellent attention to detailAbility to research and analyze dataAbility to work independently with minimal supervisionProficiency with Microsoft Office products

Preferred:

Associates DegreeCertified Provider Credentialing Specialist CPCS certification Two years of relevant credentialing experience

Scheduling Requirements:

Working Shift: Monday-Friday, 8:00AM-4:30PMDay ShiftFull-Time, 40 Hours Per Week

Essential Functions:

Work closely with New Jersey Medical School Managed Care DepartmentProcess and maintain credentialing and re-credentialing documents for healthcare providersServes as the point of contact and liaison to providers, operations regulators and leadership on credentialing-related matters regarding Medicaid and Medicare ApplicationsReviews credentialing applications for accuracy and completeness to verify provider meets credentialing criteriaMonitors application progress and submission deadlines for credentialing or re-credentialing,Conducts followup to obtain required documentation, resolve identified issues, ensure timely processing and communicate updates as neededRegularly updates and maintains credentialing database housing provider data and documentation.Conducts audits of the database and other related files to ensure current and accurate dataMaintains copies of current state licenses, certificates, malpractice coverage and any other required credentialing documentsTracks expirations to ensure timely renewalsAlerts Director of Revenue Cycle to any information regarding licensing or credentialing issues affecting reimbursement as it pertains to providers or third partiesAssists in the implementation and maintenance of processes and procedures including regulatory certification guidelines related to provider credentialingResponds to external inquiries according to policy and procedure, escalating inquiries as necessaryOther duties or special projects 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.

Benefits and Perks:

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 InsuranceDental and Vision InsuranceRetirement PlansShort & Long Term DisabilityLife & Accidental Death InsuranceTuition ReimbursementHealth Care/Dependent Care Flexible Spending AccountsWellness ProgramsVoluntary 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