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  • Hillsborough Township, NJ 08844
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Credentialing Specialist

OfficeTeam • Hillsborough Township, NJ

Posted 1 month ago

Job Snapshot

$17.10 - $19.80/Hour
Employment - Recruiting - Staffing
Admin - Clerical, Customer Service, Legal

Job Description

Ref ID: 02761-0010938189

Classification: Administrative - Medical

Compensation: $17.10 to $19.80 per hour

General Summary: A nonexempt position that ensure that all providers are appropriately credentialed by both obtaining and maintaining privileges at designated facilities. In addition, she/he takes care of their insurance enrollment with all company group contracts to provide accurate reimbursement on patient services. Knowledge of all credentialing databases, e.g. CAQH, PECOS, etc. Essential Job Responsibilities: 1. Initiate, complete, and follow-up on all credentialing and privileging applications for providers at all facilities and nursing homes. This includes, coordinating, obtaining and/or delivering all necessary requested materials for each facility. 2. Verify physicians? licenses and credentials for privileges at designated hospitals: State licenses, DEA, Board Certification, malpractice/liability insurance. 3. Follow-up on signing of employment contracts and collaborative agreements. 4. Assist practitioners with the application of Controlled Substance and DEA licenses. 5. Schedule practitioner?s interviews with the hospital?s Medical Directors. 6. Provide affiliated hospitals with updated credentials: licenses, collaborative agreements, certificate of insurance and documents. 7. Enroll providers in the group?s participating insurance plans prior to their start date. 8. Act as a resource to provide information and clarification to practitioners, staff and other interested parties concerning the credentials and enrollment of insurance plans. 9. Communicate privileging information to appropriate departments. 10. Terminate benefits and privileges as appropriate for terminated practitioners with facilities. 11. Terminate participation from Companies insurance list as appropriate for terminated practitioners. 12. Obtain NPI numbers, and update NPPES database with current information. 13. Update CMS profiles, and the PECOS internet database. 14. Input data, update and maintain the CAQH database. 15. Keep current on issues that affect billing, credentialing, and privileges. 16. Maintain all necessary materials for credentialing, including Board certificates, licenses, CME?s, PPD testing, etc. 17. Ensure that all practitioners are appropriately credentialed by obtaining and maintaining privileges at designated facilities. 18. Takes care of insurance enrollment with company contracts to provide accurate reimbursement on patient services. 19. Acts as a liaison with billing and payers to resolve insurance credentialing errors. 20. Other duties as assigned. Education: High School Diploma or equivalent. Performance Requirements: Knowledge: 1. Knowledge about the credentialing process- initial appointment, privilege delineation, ongoing monitoring and reappointment. 2. Knowledge of related accreditation and certificate requirements. 3. Knowledge of medical credentialing and privileging procedures and standards. 4. Working knowledge of Microsoft Office, and internet resources. Skills: 1. Must have excellent oral and written communication skills. 2. Must have excellent interpersonal skills and work effectively and efficiently with practitioners and management team. 3. Must be motivated as well as a self-starter who can work independently; however capable and willing to take direction as appropriate 4. Exhibit a high degree of confidentiality. Abilities: 1. Ability to organize and prioritize work and manage multiple priorities. 2. Ability to research and analyze data. If you are interested in this position please contact Tamara Morgan at 732-596-2174 and email

Job Requirements

Credentialing, Scheduling, Medical Licensing, Microsoft Word, Microsoft Office, Microsoft Excel

OfficeTeam is the world's leader in professional staffing for office support jobs, focusing exclusively on the temporary and temporary-to-full-time placement of professionals in the administrative field. We are faster at finding you work because of the depth of our client network. Specifically, our professional staffing managers connect with thousands of hiring managers in North America every week to find your office support job opportunities. We evaluate all of our OfficeTeam temporaries' skills and match them with the needs of top employers in their area.

Apply for this job now or contact us today at 888-490-4154 for additional information.

All applicants applying for U.S. job openings must be authorized to work in the United States. All applicants applying for Canadian job openings must be authorized to work in Canada.

© 2019 OfficeTeam. A Robert Half Company. An Equal Opportunity Employer M/F/Disability/Veterans.

By clicking 'Apply Now' you are agreeing to Robert Half Terms of Use.
Job ID: 02761-0010938189
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