Medical Staff Credentialing Specialist

Req #: 0000212333

Category: Professional / Management

Status: Full-Time

Shift: Day

Facility: RWJBarnabas Health Corporate Services

Department: Medical Staff

Pay Range: $52,666.00 - $72,416.00 per year

Location:

Somerset, Somerset, NJ 07052

Job Title: Credentialing Specialist

Location: SBC Corporation

Department Name: Medical Staff

Req #: 0000212333

Status: Salaried

Shift: Day

Pay Range: $52,666.00 - $72,416.00 per year

Pay Transparency

The above reflects the anticipated annual salary range for this position if hired to work in New Jersey.

The compensation offered to the candidate selected for the position will depend on several factors, including the candidate's educational background, skills and professional experience.

Job Overview

The Credentialing Specialist is accountable for performing duties related to the sending, receiving, processing, and primary source verifying applications for initial and reappointment and their related clinical privileges.

Exemplifies a culture of excellence, effective communication and collaboration, and customer service with central Medical Staff Office (MSO) leadership and staff, internal and external customers, providers, and clinical and administrative leaders within RWJBarnabas Health.

Handles, with discretion, issues that are significant, complex, multidisciplinary, sensitive, and confidential.

Possesses and develops a strong grasp of the medical staff operations and the cultures of each affiliated institution and works to collaborates with local Medical Staff Offices to facilitate timely completion of credentialing processing.

Works to develop an overall singular culture of excellence and efficiency across the enterprise.

Qualifications

Required:

• Associates degree or combination of education and experience deemed equivalent
• Successful completion of all RWJBarnabas Health orientation programs
  
  

Preferred

• Two years' prior experience in Medical Staff credentialing preferred.
• Certified Professional in Medical Staff Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS) preferred
• Knowledge of credentialing software and associated applications strongly preferred (MDStaff)
• Excellent interpersonal and communication skills
  
  

Scheduling Requirements

• Hybrid, with on-site and remote capabilities available.
  
  

Essential Functions

• Oversees and assists with application management and verification activities, preliminary analysis of application and verification information
• Analyze verification information, to include identifying red flag and/or adverse information and notifying central MSO leadership in accordance with policies
• Oversee the monitoring of expiring information such as but not limited to DEA, license, professional liability insurance, and specialty board certification status; maintain and update credentials file(s)
• Management of database entries for accuracy and completeness
• Maintenance of electronic files as required
• Effective and timely communication with local medical staff offices
• Timely and accurately prepare credential files for audit and submission to the hospitals
• Monitor staff productivity in accordance with standard turn-around-times
• Maintain a working knowledge of relevant regulatory standards (i.e., TJC, DNV and NCQA), state and federal requirements, and applicable Medical Staff Bylaws
• Assist with the development and implementation of credentialing and recredentialing workflows to ensure efficient and effective alignment of processes
• Assist in the development or revision of credentialing related forms
• Participation in special project teams as assigned
• Training of new staff as assigned - credentialing procedures, software, and workflows
• Enforcement of internal procedures and controls and problem resolution
• Takes a proactive role in monitoring and assisting in improving team productivity
• Continually strives to achieve individual, team and departmental goals
• All other duties 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.

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 Insurance
• Dental and Vision Insurance
• Retirement Plans
• Short & Long Term Disability
• Life & Accidental Death Insurance
• Tuition Reimbursement
• Health Care/Dependent Care Flexible Spending Accounts
• Wellness Programs
• Voluntary Benefits (e.g., Pet Insurance)
• Discounts Through our Partners such as NJ Devils, NJ PAC, Verizon, and more!
  
  

RWJBarnabas Health is an Equal Opportunity Employer