Medical Staff Credentialing Manager jobs in Somerset, NJ

Medical Staff Credentialing Manager manages staff that process credentialing and recredentialing applications for health care providers. Oversees department operations to ensure compliance with all regulatory standards. Being a Medical Staff Credentialing Manager implements policies and procedures to ensure that applications are properly verified and accurately uploaded into an online credentialing database system. Analyzes reports on applications and credentialing status to identify trends and improve the credentialing process. Additionally, Medical Staff Credentialing Manager prepares files for the credentialing committee and may act as a liaison to state medical licensure boards regarding the status of license applications. Requires a bachelor's degree. May require Certified Provider Credentialing Specialist (CPCS). Typically reports to a director. The Medical Staff Credentialing Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. To be a Medical Staff Credentialing Manager typically requires 5 years experience in the related area as an individual contributor. 1 - 3 years supervisory experience may be required. Extensive knowledge of the function and department processes. (Copyright 2024 Salary.com)

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Credentialing Coordinator
  • Hunterdon Health
  • Flemington, NJ FULL_TIME
  • Position Summary

    Provides general administrative and clerical tasks within the department and provides backup administrative support, if needed;  maintains critical and confidential credentialing, privileging, provider enrollment and peer review information; executive correspondence; ongoing- professional, performance evaluations (OPPE); and focused professional performance evaluations (FPPE). Recognize and maturely handle a variety of situations, often of a confidential or urgent nature.

    Primary Position Responsibilities

    1. Administrative Support - Dictate and transcribe Committee meetings, e.g. Credentialiing Committee, Medical Executive Committee,  General Medical Staff and other committees assigned by the Manager.  Assistance with events, e.g., Doctors Day delivery of appreciation gifts.
    2. Application Processing - Follow application processes, e.g. primary source verification, audit application for completeness, notify practitioner of any incomplete or oustanding documents,  self file audits when applicaiton is completed.  
    3. Provider Enrollment - Follow processes for PECOS, CAQH, Medicaid, and NPPES processes.
    4. Customer Service
    5. Data Entry - Uploading documents, linking documents, etc
    7. Unassigned Call Schedule -Update the unassigned On-Call Schedule as needed. This includes auditing the on-call schedule on a weekly basis.

    Work Contact Group (Internal/External)

    Medical Staff, Advanced Practice Professionals, staff at all levels of the organization, external organizations and their representatives, and the general public.

    Reporting Relationships

    Reports to (position):

    Manager, Medical Staff Services

    Supervises (position(s):

    None

    Qualifications

    Minimum Education:

    Required:

    High School Graduate or Equivalent

    Preferred:

    Certificate and/or Advanced Specialized or Technical Training in Medical Staff Services or Associate Degree


    Minimum Years of Experience (Amount, Type and Variation):

    Required:

    One (1) year of credentialing or provider enrollment experience 

    Preferred:

    Two (2) years of credentialing or provider enrollment experience.


    License, Registry or Certification:

    Required:

    None

    Preferred:

    Certification by NAMSS as a Certified Provider Credentials Specialist (CPCS) or the ability to become certified within the time periods established by NAMSS from date of hire.


    Knowledge, Skills and/or Abilities:

    Required:

    Ability to prioritize, work in a fast-paced environment; meet ongoing schedules and deadlines, detailed oriented, organized, good judment, self motivated, ability to multi task and work independently. Proficient in the use of multiple computer software programs

    Preferred:

  • 3 Days Ago

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Patient Care Advocate
  • Oakland Manager LLC
  • Somerset, NJ FULL_TIME
  • Summary The Patient Care Associate (PCA) is responsible for delivering an exceptional customer experience. This role ensures all sales are compliant with state regulations and that customer needs are ...
  • 1 Month Ago

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Security I
  • Oakland Manager LLC
  • Somerset, NJ FULL_TIME
  • Security Guards wanted to work for a professional industry leading company. Applicants may be assigned to a single or multiple site assignment. Applicants will need to be flexible with their schedule ...
  • 1 Month Ago

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Medical Care Services - Staff Nurse
  • Zufall Talent Team
  • Bridgewater, NJ FULL_TIME
  • Position Summary Reporting to the SVP of Clinical and Nursing Operations the Registered Nurse (RN) is a licensed professional that utilizes specialized knowledge, judgment, and nursing skills in the c...
  • Just Posted

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Medical Care Services - Staff Nurse
  • Zufall Health
  • Bridgewater, NJ FULL_TIME
  • Welcome to Zufall Health! Position Summary Reporting to the SVP of Clinical and Nursing Operations the Registered Nurse (RN) is a licensed professional that utilizes specialized knowledge, judgment, a...
  • 1 Month Ago

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Credentialing Specialist - Somerset, NJ
  • RWJBarnabas Health
  • Somerset, NJ FULL_TIME
  • Job Overview:The Credentialing Specialist is accountable for performing duties related to the sending, receiving, processing, and primary source verifying applications for initial and reappointment an...
  • 21 Days Ago

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0 Medical Staff Credentialing Manager jobs found in Somerset, NJ area

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Director, Conferences - Remote (Full Time / Contract)
  • Superfly
  • New York, NY
  • Job Description Job Description Superfly is an experience company obsessed with activating and amplifying communities ar...
  • 4/23/2024 12:00:00 AM

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Carrier Credentials Team Lead
  • World Insurance Associates LLC
  • Iselin, NJ
  • About Us World Insurance Associates is a unique insurance and professional services organization offering top products a...
  • 4/23/2024 12:00:00 AM

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Regulatory Affairs Associate Director
  • Gan & Lee Pharmaceuticals
  • Bridgewater, NJ
  • Job Description Job Description Summary This position reports to the VP, Global Regulatory Affairs. The incumbent respon...
  • 4/23/2024 12:00:00 AM

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Sr. Manager Document Management(GCP, GLP)
  • Gan & Lee Pharmaceuticals
  • Bridgewater, NJ
  • Job Description Job Description Summary This position reports to the Sr. Director, Clinical Quality Assurance, Gan & Lee...
  • 4/23/2024 12:00:00 AM

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Cyber Security Engineer - PVH Corp
  • PVH
  • Bridgewater, NJ
  • Design Your Future at PVH Cyber Security Engineer - PVH Corp POSITION SUMMARY: The Cyber Security Engineer will be deepl...
  • 4/22/2024 12:00:00 AM

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Supervisory Tax Specialist (TCO Group Manager), NTE 1 YR (12 MONTH ROSTER) (Amended)
  • Department Of The Treasury
  • Edison, NJ
  • Duties WHAT IS THE TAX EXEMPT/GOVERNMENT ENTITIES (TEGE) DIVISION? A description of the business units can be found at: ...
  • 4/22/2024 12:00:00 AM

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Credentialing Coordinator
  • Momentum Resource Solutions
  • New York, NY
  • Job Description Job Description Key Responsibilities: 1. Maintain communication with the credentialing contacts at facil...
  • 4/21/2024 12:00:00 AM

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Cybersecurity Engineer
  • Seneca Resources Company, LLC
  • New York, NY
  • QED National is seeking a Cybersecurity Engineer for a 1+ year contract located in New York, NY (various city locations,...
  • 4/21/2024 12:00:00 AM

Somerset is an unincorporated community and census-designated place (CDP) located within Franklin Township, in Somerset County, New Jersey, United States. As of the 2010 United States Census, the CDP's population was 22,083. Somerset housed one of the first Marconi Wireless Stations in the United States. According to the United States Census Bureau, the CDP had a total area of 6.444 square miles (16.692 km2), including 6.327 square miles (16.388 km2) of land and 0.117 square miles (0.304 km2) of water (1.82%)....
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Staff Credentialing Manager jobs
$108,191 to $139,515
Somerset, New Jersey area prices
were up 1.5% from a year ago

Medical Staff Credentialing Manager in Wichita Falls, TX
With the growing numbers of employed practitioners, hospitals and health systems are looking at delegated credentialing to speed up the provider enrollment process and reduce accounts receivable write-offs and claim holds which delay or decrease the revenues received from payers for the services provided to patients.
December 04, 2019
Medical Staff Credentialing Manager in Memphis, TN
Medical staff services professionals deal with credentialing every day, but how do background checks complement this critical process.
February 18, 2020
Medical Staff Credentialing Manager in Lima, OH
Medical staff services is a self-governing body within a healthcare organization and is responsible for keeping with independent practitioners who serve healthcare facilities.
January 24, 2020