Job Description

Job Description

• Job Title: Credentialing Specialist - Summit, NJ (ONSITE ROLE) NO REMOTE
• Hours: 37.5 hours/week (8:00 AM – 4:00 PM, Monday–Friday)
• Duration : 13 Weeks

MUST HAVE PROVIDER CREDENTIALING EXP. P urpose: To confirm a clinician is qualified,

Requirements:

• 2+ years of credentialing experience (medical staff office or hospital setting preferred).
• Strong knowledge of regulatory standards and credentialing best practices.
• Excellent written/verbal communication and organizational skills.
• Proficient in Microsoft Office and Echo or similar credentialing systems.
• Ability to manage multiple tasks independently and meet deadlines

Duties :-

• Verification of Credentials Confirm that healthcare providers (e.g., physicians, nurses, therapists) have valid and current licenses, certifications, education, and training. Verify board certifications, malpractice history, and work experience.
• . Compliance and Regulatory Oversight Ensure all providers meet the requirements of regulatory agencies, hospitals, and insurance networks. Maintain compliance with standards from organizations such as The Joint Commission (TJC) or NCQA.
• . Enrollment and Privileging Manage applications for providers to be enrolled with insurance payers (so they can bill for services). Handle the hospital privileging process, which authorizes providers to perform specific procedures within a facility.
• Record Maintenance Maintain accurate and up-to-date credential files for each provider. Track expiration dates for licenses, certifications, and re-credentialing timelines
• . Communication and Coordination Act as a liaison between providers, HR, medical staff offices, and payers. Communicate with state licensing

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