Credentialing Specialist jobs in Passaic, NJ

F
Recruitment & Credentialing Provider Relations Specialist
  • First Managed Care Option
  • Parsippany, NJ FULL_TIME
  • PRIMARY FUNCTION

    Responsible for the procedures associated with recruitment of Auto/Pip experienced providers into network, which includes receipt, review, and processing of credentialing application and to serve as liaison between the providers and FMCO. As such, responsible for recruitment, communication, and resolution of questions and issues between the provider and the Company.

    RESPONSIBILITIES

    Recruitment

    · Identify and communicate with potential providers via telephone and written correspondence.

    · Ensure provider experience and understanding of Auto/Pip

    · Attend meetings at providers’ offices relating to recruitment process.

    · Maintain and update electronic log of potential providers’ current status in recruitment process.

    · Ensure that all documentation is completed to facilitate a smooth credentialing process.

    · Provide weekly written report of all activities.

    Credentialing

    · Interact with potential providers.

    · Distribute, assist in completion and collect all credentialing materials.

    · Support and facilitate the credentialing process; inform the provider of credentialing status.

    · Data entry of provider information into Provider Database.

    · Prepare necessary reports for review of Quality Management Committee.

    · Assist in collecting information for appeals and sanctioning processes.

    Provider Relations

    · Identify and interact with potential providers and educate regarding FMCO policy and procedure.

    · Act as a liaison between the providers and FMCO.

    · Distribute and assist in completion of provider applications and contracts.

    · Conduct on-site visits to provider locations, as necessary.

    · Ensure that providers are adequately supplied with all necessary forms.

    · Maintain the Provider Database.

    · Assist in the resolution of provider issues.

    · Maintain the Provider QA Database.

    · Communicate with the Quality assurance supervisor, as necessary.

    · Prepare reports for the Quality Management Committee.

    · Assist in provider education program.

    · Attend in-services to update skills and information in changes in plans or procedures.

    EDUCATION, EXPERIENCE, SKILLS

    · Bachelors Degree preferred.

    · Previous experience in medical field desirous.

    · Previous experience with NJ PIP Fee Schedule and rules desirous.

    · Must exercise sound judgment, and possess ability to work with minimum supervision.

    · Excellent verbal and written communication skills.

    · Excellent negotiation skills.

    · Computer proficiency.

    · Ability to prioritize duties.

    First Managed Care Option, Inc., is an Equal Opportunity Employer and takes pride in maintaining a diverse environment. We do not discriminate in recruitment, hiring, training, promotion or any other employment practices for reasons of race, color, religion, gender, national origin, age, sexual orientation, marital or veteran status, disability, or any other legally protected status.

  • 3 Days Ago

O
Medical Receptionist
  • Omni Eye Specialist Pa
  • Parsippany, NJ TEMPORARY
  • Job description Essential Duties and Responsibilities: Responsible for completing the check-in/ registration process according to guidelines by; accurately entering all pertinent patient information, ...
  • 3 Days Ago

O
Regional Relationship Director
  • Omni Eye Specialist Pa
  • Fairfield, NJ FULL_TIME
  • Omni Ophthalmic Management Consultants (OOMC) is an ophthalmic management services organization specializing in providing support to subspecialty surgical and medical eye care practices. Headquartered...
  • 7 Days Ago

C
Specialist
  • Cedar Crest Village by Erickson Senior Living
  • Pequannock, NJ FULL_TIME
  • Location : Cedar Crest Village by Erickson Senior Living Cedar Crest is a beautiful 130-acre continuing care retirement community nestled in the Ramapo Mountains in Pompton Plains, a neighborhood of M...
  • 23 Days Ago

S
Specialist
  • Selective Insurance
  • Branchville, NJ FULL_TIME
  • Description At Selective, we don't just insure uniquely, we employ uniqueness. Our Business Selective is a midsized U.S. domestic property and casualty insurance company with a history of strong, cons...
  • 27 Days Ago

G
EH&S Specialist
  • Givaudan
  • Towaco, NJ FULL_TIME
  • With a heritage that stretches back over 250 years, Givaudan has a long history of creating scents and tastes. Creativity is at the heart of our operations, and the power to surprise is brought about ...
  • 19 Days Ago

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0 Credentialing Specialist jobs found in Passaic, NJ area

R
Credentialing Specialist
  • Russell Tobin
  • New York, NY
  • Job Description Job Description Please find below details of the position. Position: Credentialing Specialist Location: ...
  • 3/29/2024 12:00:00 AM

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Credentialing Specialist
  • PRIDE Healthcare
  • New York, NY
  • Job Description Job Description Role – Credentialing Specialist Location – New York, NY Shift – Day Pay - $25- $27/ hr C...
  • 3/28/2024 12:00:00 AM

A
Credentialing Specialist
  • Atria Consulting
  • New York, NY
  • Busy New York City Hospital Corporation is looking for an experienced and organized Credentialing Specialist. The Creden...
  • 3/28/2024 12:00:00 AM

T
Credentialing Specialist
  • Tandym Group
  • New York, NY
  • A healthcare system in New York City is seeking a Credentialing Specialist to join their team in Manhattan. In this role...
  • 3/27/2024 12:00:00 AM

P
Credentialing Specialist
  • Pride Health
  • New York, NY
  • Actively hiring "Credentialing Specialist" for hospital based in Manhattan NY pay rate is $29/hr. Title: Credentialing S...
  • 3/27/2024 12:00:00 AM

P
Credentialing Specialist
  • PRIDE Healthcare
  • Morristown, NJ
  • Job Description Job Description Position: Credentialing Specialist Location: Morristown NJ Duration: 3+ Months Contract ...
  • 3/27/2024 12:00:00 AM

I
Credentialing Specialist
  • Infojini
  • Morristown, NJ
  • Job Description Job Description Position: Credentialing Specialist Location: Onsite: 475 South Street, AHS Corporate Off...
  • 3/27/2024 12:00:00 AM

A
Credentialing Specialist
  • ATRIA CONSULTING LLC
  • New York, NY
  • Job Description Job Description Busy New York City Hospital Corporation is looking for an experienced and organized Cred...
  • 3/25/2024 12:00:00 AM

According to the United States Census Bureau, the city had a total area of 3.244 square miles (8.401 km2), including 3.146 square miles (8.149 km2) of land and 0.098 square miles (0.253 km2) of water (3.01%). Unincorporated communities, localities and place names located partially or completely within the city include Davis Bridge and Pleasant Plains. Passaic's only land border is with neighboring Clifton, which borders Passaic to the north, south, and west. The Passaic River forms the eastern border of Passaic. Four additional neighboring towns in Bergen County immediately across the river fr...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Credentialing Specialist jobs
$47,413 to $60,039
Passaic, New Jersey area prices
were up 1.5% from a year ago

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