Credentialing Specialist Job at Insight Global, Morristown, NJ

TzZzNEQzaDFNeWtKdTZzSmxoRUpWZ1Ztc2c9PQ==
  • Insight Global
  • Morristown, NJ

Job Description

Title: Credentialing Specialist

Location: Hybrid, Morristown NJ!

Contract: 6 months+

Pay Rate: $18-$30

Day to Day:

Our top Healthcare client in NJ is looking for a Credentialing Specialists to sit in Morristown, NJ. This person will maintain credentials for Payor/Provider enrollment. They will be responsible for submission of managed care, Medicare, Medicaid applications and monitor and track these applications through the payer credentialing process.

  • Assists with the coordination of daily activities as it relates to Delegated Credentialing requirement. Ensures that verifications are within the appropriate time frames as stated by NCQA guidelines.
  • Submits complete provider files to Credentialing Corporation of America for primary source verification.
  • Performs data quality checks on files that have gone through primary source verification.
  • Review/prepares files to present at monthly AMG Credentialing Committee meeting for approval.
  • Summarizes and documents medical malpractice and adverse action claims to present to committee.
  • Submits monthly Credentialing Committee meeting minutes to Chief Medical Officer.
  • Participates in pre-delegated carrier file audits to be eligible for delegated credentialing.
  • Participates in delegated carrier file audits to remain in compliance with NCQA standards.

Must Haves:

-2+ years’ experience in Payer/Provider credentialing

-Payor Enrollment experience

- credentialing high-volume workload

-working experience using ECHO- credentialing software

-experience with CAQH- web-based data repository for credentialing data

-showing growth in experience at one company/healthcare system

Pluses :

- NAMSS certification- provider credentialing and medical services management certification

Job Tags

Contract work, Work experience placement,

Similar Jobs

Walt Disney Company

Experienced Pastry Cook - Full Time, $37.86/hour + $1,000 Hiring Bonus Job at Walt Disney Company

 ...wedding cakes, and custom amenities Able to understand and interpret BEOs, Private dining and restaurant orders Utilize proper food safety, sanitation and HACCP guidelines throughout all bakeshop food prep areas Check and maintain proper temperatures throughout... 

Thermo Fisher Scientific

Research Scientist - Regulatory Submission / CMC Job at Thermo Fisher Scientific

 ...Shift (Days) Environmental ConditionsAdherence to all Good Manufacturing Practices (GMP) Safety Standards Job DescriptionAt Thermo Fisher Scientific, youll discover meaningful work that makes a positive impact on a global scale. Join our colleagues in bringing our... 

Southern Oregon University

(Pool) Temporary Clothless Art Model Job at Southern Oregon University

 ...applying, qualified applicants will be considered for Clothless/Nude Art Model appointments that may become available at Southern Oregon...  ...be responsible for posing, nude or clothed, for Art and drawing classes. The primary purpose of the Art Model is to provide art... 

ArcSite

Senior Manager, Community & Engagement Job at ArcSite

 ...design experiences. About the Role: Were looking for a creative and strategic marketer to lead and scale ArcSites community and engagement programs. In this role, youll own our community hubs, organic social presence, ambassador initiatives, and local field engagement... 

Government Jobs

Police Records Assistant I Job at Government Jobs

 ...Government Jobs - Full-Time - $36,192.00 - $48,492.00 Annually To perform a variety of routine clerical duties in support of the Police Department records program; to process various police reports and enter data into records management system; to maintain highly confidential...