Summary
The Credentialing Specialist secures and maintains the critical provider credentials that keep our Ambulatory Surgery Center (ASC) compliant, operational, and thriving. In this role, you will own the end-to-end credentialing and re-credentialing lifecycle for all medical staff—from initial application to full onboarding. You will serve as our internal expert on state licensing and facility privileges while leading the enrollment process for both government and commercial payors to ensure seamless care delivery and maximum reimbursement.
Responsibilities
- Ensure the quality, accuracy and timeliness of the primary source verification (PSV) process for incoming physicians.
- Prepare, populate, and submit comprehensive initial credentialing and re-credentialing applications.
- Plan, manage, and execute the cyclical reappointment process for all active medical staff members.
- Partner with hospitals and providers to streamline document collection and facilitate the credentialing workflow.
- Oversee the continuous updating of credentialing files, tracking tools, and internal task lists.
- Execute and complete all designated credentialing tasks within the facility’s onboarding checklist.
- Perform monthly audits to monitor, track, and update expiring documents (e.g. licenses, DEA, board certifications).
- Document all workflow steps, including provider numbers, effective dates, and official correspondence.
- Execute timely outreach regarding pending credentials or documentation bottlenecks to prevent onboarding delays.
- Serve as the primary liaison for credentialing updates between physicians, external clients and internal teams.
- Help maintain and distribute the active provider and physician schedules
- Manage standard clerical functions, including high-volume data entry, faxing, scanning and digital filing.
- Assist other areas as needed.
- Maintain a safe, clean and organized workspace.
- Other duties as assigned
