Credentialing and Privileging Specialist
$47,840–$62,400 year
HybridCherry Hill, New Jersey, United States
Job Summary
Lead, coordinate, and monitor the privileging, credentialing, and re-credentialing processes for medical staff, allied health professionals, and delegated providers. Independently process requests for privileges, conduct background investigations, and verify all application components. Manage initial appointment and reappointment cycles while ensuring compliance with federal, state, and regulatory bodies. Establish CAQH accounts, prepare credential files for Board presentation, and submit enrollment applications to managed care insurers. Maintain the credentialing database, verify provider demographics, and resolve issues regarding NPI numbers. Provide weekly status updates and respond to inquiries from internal and external customers. This hybrid role in Cherry Hill, NJ, requires 3 days in the office and 2 days remote work.
Required Qualifications
- High school diploma
- At least 3 years' experience
- 2 years directly related to hospital, physician group, managed care, outpatient practice or human service field credentialing
- Demonstrated ability to effectively communicate both verbally and in written form
- Ability to think and work independently
- Valid driver's license in incumbent's legal name and current address with no provisional restrictions
- Minimum 18 years of age
- Operative knowledge of MS Office Word and Excel spreadsheets
Desired Qualifications
- National Association Medical Staff Services (NAMSS) certification as a Certified Medical Services Manager (CPMSM)
- Certified Provider Credentials Specialist (CPCS)
- Ability to be certified within one year
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