Physician Credentialing Specialist Job Overview We are seeking a detail-oriented and experienced Physician Credentialing Specialist to support our team at a high-volume Ambulatory Surgery Center (ASC) . This role is responsible for overseeing and maintaining all aspects of the credentialing and recredentialing processes for providers. The ideal candidate will have a minimum of 3 years of credentialing experience , preferably in a surgery center or hospital setting, and a thorough understanding of regulatory standards and compliance requirements.

Key Responsibilities Credentialing & Compliance:

Manage the full credentialing and recredentialing process for all providers practicing at the surgery center. Conduct and document primary source verifications including, but not limited to: State medical licenses DEA and CDS registrations Board certifications Medical education and training Work history and malpractice history NPDB (National Practitioner Data Bank) reports OIG and SAM exclusion checks Identify and resolve discrepancies, incomplete information, or expired credentials and ensure timely follow-up. Maintain compliance with medical staff bylaws , AAAHC standards , CMS , and applicable state and federal laws .

Data Management & Reporting:

Maintain up-to-date and accurate provider records in credentialing software and internal databases. Track expiration dates and ensure timely renewal of licenses, certifications, and malpractice coverage. Generate reports related to credentialing status, expirables, and compliance audits.

Administrative Support:

Collaborate directly with the Administrator to ensure credentialing files and reporting meet regulatory and accreditation requirements. Support the Medical Staff Office and assist with audits, surveys, and day-to-day credentialing functions.

Communication & Confidentiality:

Respond to internal and external inquiries regarding credentialing requirements and provider status. Communicate clearly with providers via email or call to obtain missing information or updates to their credentials. Maintain strict confidentiality of provider and patient information in compliance with HIPAA and organizational policy.

Additional Duties:

Adhere to all ambulatory surgery center policies, including:

Attendance :

Arrives on time, uses timekeeping tools accurately, and requests time off appropriately.

Professional Conduct :

Demonstrates respectful behavior and complies with rules of conduct.

HIPAA Compliance :

Maintains the privacy of all protected health information. Perform other tasks as assigned by the Administrator .

Qualifications:

Minimum of 3 years credentialing experience required , ideally in a medical, an ambulatory surgery center or hospital setting. Knowledge of credentialing regulations and processes including primary source verification standards. A must New jersey and New York Familiarity with AAAHC, CMS, and state licensure regulations. Strong organizational skills and attention to detail. Excellent communication and time management skills. Proficiency in credentialing software and Microsoft Office Suite.

Job Type:

Full-time Pay:

$22.00 - $24.00 per hour

Benefits:

401(k) Dental insurance Health insurance Paid time off Vision insurance

Experience:

Physician Credentialing:

2 years (Required) Ability to

Commute:

Saddle Brook, NJ 07663 (Required)

Work Location:

In person