Credentialing Specialist

Company Description St. Charles Surgical Hospital, LLC is a specialized healthcare facility and the only hospital in the world dedicated exclusively to breast reconstruction. Located in New Orleans, LA, the hospital is globally recognized for providing advanced breast reconstructive surgical services in a patient- and family-focused environment. Its mission emphasizes healing, compassion, and excellence in surgical care. Team members collaborate to deliver a supportive experience for patients and their families throughout the reconstructive journey.

We are seeking a highly organized and detail-oriented Credentialing Specialist to join our Human Resources team. This position will play a critical role in coordinating the credentialing and recredentialing of physicians and other clinical providers across both our clinic and hospital environments.

The Credentialing Specialist will manage the credentialing lifecycle from initial application through ongoing maintenance, including physician credentialing, hospital medical staff applications and privileges, payer enrollment, licensing, certifications, and recredentialing.

This is an excellent opportunity for a healthcare professional who enjoys working independently, managing multiple deadlines, building relationships with physicians and healthcare organizations, and ensuring that providers are fully credentialed and ready to practice.

• Coordinate initial and recredentialing processes for physicians and applicable advanced practice providers.
• Collect, verify, and maintain provider credentials, including medical licenses, DEA registrations, board certifications, NPI information, malpractice coverage, education, training, work history, and other required documentation.
• Manage provider enrollment and credentialing applications for commercial insurance plans, Medicare, Medicaid, and other payers.
• Maintain and monitor provider information in CAQH and other credentialing systems.
• Track license, certification, insurance, and other expiration dates and proactively initiate renewals.
• Maintain accurate and audit-ready electronic credentialing files.
• Coordinate initial appointments and reappointments with affiliated hospitals and healthcare facilities.
• Prepare and submit medical staff applications and supporting documentation.
• Coordinate hospital credentialing, privileging, and onboarding requirements.
• Track hospital privileges, committee review dates, temporary privileges, and reappointment deadlines.
• Communicate with hospital Medical Staff Offices regarding application status, missing documentation, and outstanding requirements.
• Assist with changes to privileges, practice locations, hospital affiliations, and scope of practice.

• Partner with Human Resources, physician leadership, practice leadership, and hospital Medical Staff Offices to coordinate provider onboarding.
• Develop provider-specific credentialing checklists and timelines.
• Monitor credentialing progress and communicate outstanding requirements to physicians and leadership.
• Help ensure providers complete all required credentialing and enrollment activities prior to their anticipated start dates.

• Conduct primary-source verification of licenses, certifications, education, training, and other credentials as required.
• Maintain accurate credentialing records in accordance with regulatory, accreditation, payer, and organizational requirements.
• Assist with credentialing audits and regulatory/accreditation surveys.
• Maintain credentialing databases, tracking reports, and credentialing calendars.
• Identify potential credentialing delays or compliance issues and elevate them appropriately.
• Develop and maintain standardized…