Credentialing & Provider Enrollment Specialist Princeton Radiology Associates - 2.7 Princeton, NJ Job Details Full-time From $27 an hour 1 day ago Benefits Profit sharing AD&D insurance Disability insurance Health insurance Dental insurance 401(k) Paid time off Vision insurance 401(k) matching Life insurance Retirement plan Qualifications Research High school diploma or GED Attention to detail Organizational skills Associate's degree Full Job Description Great opportunity to join our expanding practice and be part of our commitment to bringing empathy, compassion and a remarkable imaging experience to the communities we serve! Princeton Radiology Associates is a physician group practice providing diagnostic imaging services at 14 imaging centers and two hospitals throughout New Jersey and Pennsylvania.

Summary of Position:

The full-time Credentialing & Provider Enrollment Specialist is responsible for managing all aspects of provider credentialing, recredentialing, payer enrollment, hospital privileging, licensure and regulatory compliance for physicians and advanced practice providers. This position serves as the primary liaison between the practice, hospitals, government and commercial payers, and credentialing organizations to ensure providers and facilities remain appropriately credentialed, enrolled, and eligible for reimbursement. This position plays a critical role in supporting new provider onboarding, facility expansions, acquisitions, and ongoing compliance requirements while maintaining accurate provider records and ensuring timely completion of all credentialing and enrollment activities.

Essential Job Responsibilities:

• Coordinate provider, facility and hospital enrollment activities with Medicare, Medicaid, commercial insurance carriers, hospitals and other contracted entities.
• Manage credentialing and enrollment timelines, ensuring applications, supporting documentation, and renewals are submitted timely and accurately for both physicians and facilities.
• Research payer participation requirements and resolve enrollment-related issues that may impact provider reimbursement or network participation.
• Track payer applications, effective dates, participation status and network approvals to ensure timely reimbursement and uninterrupted provider participation.
• Serve as the primary liaison between the practice, payers, hospitals, credentialing organizations, and regulatory agencies regarding provider enrollment and participation matters.
• Coordinate hospital appointments, reappointments, and privileging activities for physicians and advanced practice providers.
• Maintain provider records within CAQH and enrollment databases and ensures the accuracy of provider demographic, licensure and practice information.
• Support organizational growth initiatives, including new facility openings, acquisitions, and expansion projects requiring provider or facility enrollment.
• Track medical licenses, CDS and DEA certification expirations for all company physicians to ensure timely processing of renewals.
• Coordinate onboarding activities for newly hired physicians and advanced practice providers, including payer enrollment, hospital credentialing and privileging, licensure, and regulatory requirements.
• Maintain detailed tracking systems and regularly report the status of pending applications, enrollments, renewals, and projects to management.
• Monitor BLS and ACLS certifications; enrolls physicians in courses to recertify if needed.
• Ensure radiologists are up to date with required immunizations (i.e. PPD, Influenza, Covid-19 etc).
• Other duties as assigned.

Qualifications:

• HS Diploma or equivalent required. Associate's degree preferred.
• Minimum of 3 to 5 years of healthcare credentialing and provider enrollment experience, preferably within a physician practice, radiology group, or multi-specialty group.
• CPCS (Certified Provider Credentialing Specialist) certification preferred but not required.
• Demonstrated experience managing multiple concurrent projects, deadlines, and stakeholder relationships in a complex healthcare environment.
• Proven experience with Medicare & Medicaid enrollment, commercial payer enrollment, provider revalidation, and facility enrollment processes; strong knowledge of Medicare and commercial carrier regulations and credentialing requirements.
• Working knowledge of CAQH, NPPES, Medicare, Medicaid, Novitas, and major commercial insurance carriers and networks.
• Experience coordinating provider enrollment and credentialing activities across multiple locations and healthcare facilities.
• Understanding and compliance with all applicable Federal, State, and Local laws, accreditation standards (e.g., ACR, ABR) and regulations relating to job duties, as well as company policies and procedures.
• Excellent verbal and written communications skills, with the ability to interact professionally with providers, staff, payers, hospitals, and external organizations.
• Ability to multitask & adapt to change in a fast-paced environment.
• Must possess exceptional organizational skills with acute attention to detail, accuracy and deadlines.

Princeton Radiology offers competitive compensation with a comprehensive benefits package, featuring health, dental & vision insurance, company-paid life and long-term disability insurance, generous PTO (increases with years of service), sick time and 401k profit sharing plan with company match and profit-sharing contribution. For more information regarding Princeton Radiology, visit our website at www.princetonradiology.com We regret we are unable to respond to each resume received. Only those selected for an interview will be contacted. No phone calls or agencies please. Princeton Radiology Associates is an Equal Opportunity Employer. Any listed pay scale is not a guarantee of a particular wage. Actual base pay could vary based on non-discriminatory factors including but not limited to work experience, education, location, licensure requirements, proficiency and qualifications required for the role.

Pay:

From $27.00 per hour

Benefits:

401(k) 401(k) matching AD&D insurance Disability insurance Health insurance Life insurance Paid time off Retirement plan Vision insurance Application Question(s): Are you proficient in Microsoft Word & Excel? Do you have experience managing multiple concurrent projects, deadlines, and stakeholder relationships in a complex healthcare environment. Do you have proven experience with Medicare & Medicaid enrollment, commercial payer enrollment, provider revalidation, and facility enrollment processes; strong knowledge of Medicare and commercial carrier regulations and credentialing requirements?

Education:

High school or equivalent (Required)

Experience:

healthcare credentialing and provider enrollment: 3 years (Required) Ability to

Commute:

Princeton, NJ 08540 (Required)

Work Location:

In person