A-Line Staffing is now hiring a Credentialing Specialist in Summit, NJ.
The Credentialing Specialist will be working for a Fortune 500 Company and has career growth potential. See additional details below.
Credentialing Specialist Highlights
- The pay for this position is $35.00 per hour.
- Schedule: Monday-Friday, 8:00 AM - 4:00 PM (7.5-hour shift)
- Onsite position
- This position is a full-time contract opportunity.
Responsibilities
- Enforce regulatory compliance and quality assurance for all credentialing processes.
- Prepare and maintain reports of credentialing activities including accreditation, membership, and privileges.
- Process applications for initial applicants and reappointments (125-200 per quarter).
- Collect and verify credentialing data such as education, training, experience, and licensure.
- Maintain and update accurate provider information in the Echo credentialing database.
- Prepare materials for Credentials Committee, MEC, and Board of Trustees meetings.
- Ensure all credentialing complies with federal, state, and bylaws of each facility.
- Schedule and occasionally attend medical staff meetings; record and manage meeting minutes.
- Process and collect dues for site-based medical staff.
- Track license and certification expirations and advise providers on renewal timelines.
- Maintain confidentiality of all provider information.
- Perform other administrative tasks as assigned.
Requirements
- High School Diploma or equivalent required.
- Prior knowledge and experience with the medical staff credentialing process required.
- Excellent verbal and written communication skills.
- Strong research, analytical, and data management abilities.
- Ability to work independently and manage multiple priorities simultaneously.
- Strong organizational skills and attention to detail.
- Proficiency with computer systems and Microsoft Office; experience with Echo database preferred.
- Must not be focused on insurance credentialing-this role is strictly medical staff credentialing.
Benefits Available
- Benefits are available to full-time employees after 90 days of employment.
- A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates.
If you are interested in this Credentialing Specialist position, APPLY, or contact
153670
- Processing insurance claims, expediting billing and payments for insurance claims
- Denied claims with insurance carriers
- Assemble appropriate information regarding claims
- Resolve claims issues to ensure prompt and accurate claims adjudication
- Adjusting health claims in accordance with claims policies and procedures
- Examining and resolving medical claims
- Perform complex healthcare payer claims processing
- Approved payments in the claims system
- Process standard claims or adjustments
- Negotiate claims resolution within granted authority
- Monitor training and ensure accurate claims processing
- Resolve any open issues with claims
- Settle cargo claims from shippers
- Protect operations by keeping claims information
- Maintain paper claims and on-line claim data
- Negotiate settlements on some claims
- Assist customers throughout the claims process and settle undisputed non-injury claims
- Assist claims department as needed withinventory and complex claim issues
- Ensure any changes required to claims
- Submit claims on a daily basis