Credentialing Specialist

Job Title: Credentialing Specialist
Location: Onsite – Morristown, NJ up to 50 miles of 07960
Duration: 3 Months+ W2 contract with high possibility of extension based on performance and business needs

Shift: 8:00 AM – 4:00 PM EST
Pay Range: $35/Hour. on W2
 
Job Summary:
We are seeking a highly organized and detail-oriented Credentialing Specialist to join our team in Morristown, NJ. This role is essential in ensuring compliance, accuracy, and timely processing of credentialing activities for physicians and allied health practitioners. The ideal candidate will have strong analytical skills, excellent communication abilities, and prior experience in credentialing within a healthcare environment.
 
Essential Functions:

• Enforce regulatory compliance and quality assurance standards.
• Prepare and maintain reports related to credentialing activities including accreditation, membership, and facility privileges.
• Ensure all information meets legal, federal, and state guidelines during application processing.
• Manage credentialing processes for initial applicants and reappointments (approximately 125–200 quarterly).
• Collect, verify, and process large volumes of verification and accreditation information.
• Maintain accurate provider information in the Echo database, including education, training, licensure, and experience.
• Prepare documentation for Credentials Committee, MEC, and Board of Trustees meetings.
• Set up and maintain provider information in Echo and online credentialing databases.
• Ensure compliance with Bylaws at all locations for credentialing processes.
• Schedule, attend, and take minutes for site-based medical staff meetings as needed.
• Process and collect dues for site-based medical staff.
• Track license and certification expiration dates for all providers.
• Maintain strict confidentiality of provider information.
• Perform all other duties as assigned.

 
Responsibilities:
Verification of Credentials:

• Confirm providers have valid and current licenses, certifications, education, and training.
• Verify board certifications, malpractice history, and professional experience.

Compliance & Regulatory Oversight:

• Ensure all providers meet requirements for regulatory agencies, hospitals, and insurance networks.
• Maintain compliance with standards such as The Joint Commission (TJC) and NCQA.

Enrollment & Privileging:

• Manage insurance payer enrollment applications.
• Oversee the hospital privileging process for authorized procedures.

Record Maintenance:

• Maintain accurate, up-to-date credential files.
• Track expirations for licenses, certifications, and re-credentialing deadlines.

Communication & Coordination:

• Serve as a liaison between providers, HR, medical staff offices, and payers.
• Communicate with state licensing agencies and other regulatory bodies.

 
Education & Qualifications:

• Knowledge of the credentialing process required.
• Excellent organizational skills with the ability to manage multiple priorities.
• Strong verbal and written communication skills.
• Ability to research, analyze data, and work independently.
• Ability to establish and maintain effective working relationships.
• Excellent computer skills; experience with Echo is a plus.