NJ Retina is currently seeking an enthusiastic Credentialing Specialist.
The Credentialing Specialist will be responsible for all aspects of credentialing activities to ensure effective operations, compliance with government/state regulations, and that all providers are appropriately credentialed. This position requires professionalism, collaboration, and excellent decision-making skills.
- Compiles and maintains current and accurate data for all providers. Completes provider credentialing and recredentialing applications; monitors applications and follows-up as needed.
- Maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers.
- Maintains corporate provider contract files.
- Preserves knowledge of current health plan and agency requirements for credentialing providers.
- Tracks license and certification expiration for all providers to ensure timely renewals.
- Ensures practice addresses are current with health plans, agencies and other entities.
Education: Bachelor’s degree in in Public Health, Health Informatics or related filed related
Experience: 3-5 years of experience in healthcare compliance, credentialing and regulatory field
- Knowledge of HIPAA, HITECH and other rules and regulations in the healthcare industry
- Relies on experience and judgement to plan and accomplish goals
- Excellent verbal and written communication skills
- Ability to work autonomously and collaborate with all levels of management
- Preferred CHC or CHPC qualified
- Healthcare billing and coding experience helpful
NJRetina is an Equal Opportunity Employer
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