We are looking for a detail-oriented Credentialing Specialist to support provider credentialing and enrollment activities for a Long-term Contract position based in the Bridgewater, New Jersey area. In this role, you will help ensure practitioners meet regulatory, accreditation, and organizational standards by coordinating verification, documentation, and record maintenance. The ideal candidate is organized, accurate, and comfortable working with sensitive information while partnering with internal teams and external entities.
Responsibilities:
Conduct primary source verification for practitioner credentials, including education, licensure, certifications, and training history.
Review submitted applications for accuracy and completeness, and follow up with providers to obtain outstanding documentation.
Maintain current credentialing, privileging, and enrollment files while ensuring records remain organized and audit-ready.
Coordinate provider enrollment activities with payer and regulatory platforms, including government and industry credentialing databases.
Upload, organize, and associate supporting documents within credentialing systems to keep provider profiles current.
Enter and update provider data in internal databases with a strong focus on accuracy, consistency, and timeliness.
Perform routine reviews of on-call schedules and update unresolved assignments on a weekly basis.
Communicate with physicians, advanced practice providers, hospital personnel, and external organizations to resolve credentialing and enrollment matters.
