Medical Staff Credentialing Specialist

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$52,666.00/yr - $72,416.00/yr

Req #:
Category: Clerical / Administrative
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

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.

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. The role 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.

The specialist handles, with discretion, issues that are significant, complex, multidisciplinary, sensitive, and confidential. Possessing and developing a strong grasp of the medical staff operations and the cultures of each affiliated institution, the specialist collaborates with local Medical Staff Offices to facilitate timely completion of credentialing processing and works to develop an overall singular culture of excellence and efficiency across the enterprise.

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

• 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

• This is an onsite role in Somerset, NJ with hybrid/remote capabilities if/when available

• Oversee and assist with application management and verification activities, preliminary analysis of application and verification information
• Analyze verification information, including identifying red flag and/or adverse information and notifying central MSO leadership in accordance with policies
• Oversee the monitoring of expiring information such as DEA, license, professional liability insurance, and specialty board certification status; maintain and update credentials file(s)
• Manage database entries for accuracy and completeness
• Maintain 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

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…