Job Summary:

The Credentialing Specialist provides coordination and completion of credentialing and re-credentialing activities for new and participating providers of the Medical Group and RWJBH Health System. This position is responsible for the review of applications, verification of credentials, timely application processing, and maintenance of provider credentialing database and related information.

Please note, this is a temporary, full-time position.

Essential Functions:

• Coordinates and facilitates the credentialing process for appointment and reappointment of provider privileges to system practices, hospitals and related facilities.
• Serves as the point of contact and liaison to providers, operations, regulators, and leadership on credentialing related matters.
• Reviews credentialing applications for accuracy and completeness to verify provider meets credentialing criteria.
• Monitors application progress and submission deadlines for credentialing or re-credentialing. Conducts follow-up to obtain required documentation, resolve identified issues, ensure timely processing, and communicate updates as needed.
• Updates and maintains credentialing database housing provider data and documentation. Regularly conducts audits of the database and other related files to ensure current and accurate data.
• Maintains copies of current state licenses, certificates, malpractice coverage and any other required credentialing documents. Tracks expirations to ensure timely renewals.
• Alerts Vice President of Support Services to any information regarding licensing or credentialing issues affecting reimbursement as it pertains to providers or third parties.
• Assists in the implementation and maintenance of processes and procedures including regulatory certification guidelines related to provider credentialing.
• Responds to external inquiries according to policy and procedure, escalating inquiries as necessary.
• Other duties or special projects as assigned.

Job Requirements:

• High School Diploma or GED equivalent, required
• Associates Degree, preferred
• Certified Provider Credentialing Specialist (CPCS) certification, preferred
• Two years of relevant credentialing experience, preferred
• Knowledge and understanding of credentialing processes
• Ability to organize, prioritize work and manage multiple priorities simultaneously
• Excellent verbal and written communication skills
• Excellent attention to detail
• Ability to research and analyze data
• Ability to work independently with minimal supervision
• Proficiency with Microsoft Office products

RWJBarnabas Health is the most comprehensive health care delivery system in New Jersey, with a service area covering five million people. The system includes eleven acute care hospitals Clara Maass Medical Center in Belleville, Community Medical Center in Toms River, Jersey City Medical Center in Jersey City, Monmouth Medical Center in Long Branch, Monmouth Medical Center Southern Campus in Lakewood, Newark Beth Israel Medical Center in Newark, RWJUH- New Brunswick, RWJUH- Somerset in Somerville, RWJUH- Hamilton, RWJUH- Rahway and Saint Barnabas Medical Center in Livingston; three acute care children s hospitals and a leading pediatric rehabilitation hospital (Children s Specialized Hospital), a freestanding 100-bed behavioral health center, trauma centers, a satellite emergency department, ambulatory care centers, geriatric centers, the state s largest behavioral health network, comprehensive home care and hospice programs, fitness and wellness centers, retail pharmacy services, a medical group, multi-site imaging centers and an accountable care organization.

RWJBarnabas Health Medical Group is a multispecialty group practice comprised of highly trained and experienced world class primary and specialty care physicians. RWJBarnabas Health Medical Group physicians provide compassionate and innovative cutting-edge care for people at every stage of life at easily accessible facilities conveniently located throughout New Jersey. Backed by the vast continuum of resources of RWJBarnabas Health, the largest not-for-profit integrated health care delivery system in New Jersey and one of the largest in the nation, our dedicated physicians and expertly trained supporting staff continuously strive for clinical excellence.

Equal Opportunity Employer