ASC Credentialing Specialist

Description

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

Requirements

Education

• High school diploma or equivalent required.
• College degree preferred.

Certifications/Licensure

• CPCS certification preferred.

Experience

• Two years previous credentialing experience in an Ambulatory Surgery Center or

hospital setting required.

Technical Skills

• Strong computer skills to include Google Suite and Microsoft Word and Excel.
• Knowledge of NCQA and TJC credentialing standards preferred.

Soft Skills

• Strong written and verbal communications skills.
• Must have strong interpersonal skills and ability to work well with individuals at all levels
• within practice.
• Strong organizational skills; detail oriented.
• Ability to develop and maintain paper and on-line filing systems.
• Must work efficiently under deadlines.
• Requires ability to read, write, hear, speak and understand English.

Physical Requirements

• Stand or sit for extended periods of time.
• Position is primarily sedentary and requires repetitive motion associated with computer
• data entry.
• Occasionally lifting of boxes up to 25 lbs. may be required.

This description is intended to provide only basic guidelines for meeting job requirements.  Duties and responsibilities, experience, qualifications, skills, supervisory relationship, physical/mental demands, and environmental/ working conditions may change as needs evolve.

Base salary offers for this position may vary based on factors such as location, skills and relevant experience. We offer the following benefits to those who are benefit eligible (30+ hours a week): medical, dental, vision, life and AD&D insurance, long and short term disability, 401k program with company match and profit sharing, wellness program, health savings accounts, flexible savings accounts, ID protection plan and accident, critical illness and hospital benefits.

In addition, we offer paid holidays and paid time off. Illinois Bone and Joint Institute, LLC is an equal opportunity employer. All employment decisions are based on qualifications, merit, and business need, without regard to race, color, religion, age, sex, national origin, disability status, military or veteran status, sexual orientation, gender identity and expression, or any other characteristic protected by federal, state or local laws. This policy applies to recruitment and placement, promotion, training, transfer, retention, rate of pay and all other terms and conditions of employment.