Position Summary
A healthcare organization is seeking an experienced
Credentialing Specialist
to manage and support the full medical staff credentialing lifecycle. This role is responsible for ensuring that physicians and allied health professionals meet all regulatory, accreditation, and organizational requirements for appointment and reappointment. The Credentialing Specialist serves as a key liaison between administration and medical staff while maintaining the highest standards of accuracy, confidentiality, and compliance.
Key Responsibilities Credentialing & Medical Staff Support
Prepare complete and accurate credentialing files and enter all required data into electronic credentialing systems
Manage initial appointments, reappointments, and ongoing credentialing processes for physicians and allied health professionals
Coordinate and track licensure, certifications, DEA, malpractice insurance, and required background checks
Identify, track, and resolve credentialing deficiencies in a timely manner, escalating issues as appropriate
Initiate and manage physician correspondence related to outstanding items, suspensions, or compliance issues
Prepare credentialing files, action items, and reports for Credentials Committee and Medical Executive Committee (MEC) meetings
Attend applicable committee meetings and present credentialing data as required
Prepare monthly and forward‑looking reports on outstanding credentialing items and upcoming expirations
Maintain expert‑level knowledge of Medical Staff Bylaws, Rules, and Regulations
Regulatory & Accreditation Support
Stay current on federal and state regulations, accreditation standards, and medical staff governance requirements
Participate in accreditation surveys, complaint investigations, and regulatory inquiries (e.g., state medical board reviews)
Assist with OPPE and FPPE tracking and physician profile management
Review bylaws and policies for compliance with new or updated standards
Administrative & Cross‑Functional Collaboration
Serve as a communication link between medical staff, administration, and leadership
Assist Medical Directors and executive medical leadership with committee preparation, agendas, and confidential materials
Respond professionally to credentialing verification requests from external entities
Maintain electronic and hard‑copy medical staff files in accordance with policy
Collaborate effectively with facility‑based teams and corporate partners
Travel to facility locations as needed
Position Qualifications Education
High school diploma or equivalent required
Associate degree in healthcare, business administration, or related field preferred
Bachelor’s degree in healthcare or related field strongly preferred
Experience
Minimum of 3 years of experience in a healthcare medical staff credentialing environment preferred
Experience supporting accreditation surveys and regulatory reviews
Strong data entry, reporting, and document management experience
Proficiency in Microsoft Office and electronic credentialing systems
Working knowledge of medical terminology and healthcare office procedures
Licensure / Certification
Certified Provider Credentialing Specialist (CPCS) preferred
Willingness to obtain CPCS certification within one year of hire if not already certified
High attention to detail and accuracy
Ability to manage large volumes of complex information
Strong written and verbal communication skills
Professional judgment when handling confidential and sensitive information
Ability to build effective working relationships with physicians, NPs, PAs, and allied health professionals
Strong organizational skills with the ability to meet deadlines in a regulated environment
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Credentialing Specialist
to manage and support the full medical staff credentialing lifecycle. This role is responsible for ensuring that physicians and allied health professionals meet all regulatory, accreditation, and organizational requirements for appointment and reappointment. The Credentialing Specialist serves as a key liaison between administration and medical staff while maintaining the highest standards of accuracy, confidentiality, and compliance.
Key Responsibilities Credentialing & Medical Staff Support
Prepare complete and accurate credentialing files and enter all required data into electronic credentialing systems
Manage initial appointments, reappointments, and ongoing credentialing processes for physicians and allied health professionals
Coordinate and track licensure, certifications, DEA, malpractice insurance, and required background checks
Identify, track, and resolve credentialing deficiencies in a timely manner, escalating issues as appropriate
Initiate and manage physician correspondence related to outstanding items, suspensions, or compliance issues
Prepare credentialing files, action items, and reports for Credentials Committee and Medical Executive Committee (MEC) meetings
Attend applicable committee meetings and present credentialing data as required
Prepare monthly and forward‑looking reports on outstanding credentialing items and upcoming expirations
Maintain expert‑level knowledge of Medical Staff Bylaws, Rules, and Regulations
Regulatory & Accreditation Support
Stay current on federal and state regulations, accreditation standards, and medical staff governance requirements
Participate in accreditation surveys, complaint investigations, and regulatory inquiries (e.g., state medical board reviews)
Assist with OPPE and FPPE tracking and physician profile management
Review bylaws and policies for compliance with new or updated standards
Administrative & Cross‑Functional Collaboration
Serve as a communication link between medical staff, administration, and leadership
Assist Medical Directors and executive medical leadership with committee preparation, agendas, and confidential materials
Respond professionally to credentialing verification requests from external entities
Maintain electronic and hard‑copy medical staff files in accordance with policy
Collaborate effectively with facility‑based teams and corporate partners
Travel to facility locations as needed
Position Qualifications Education
High school diploma or equivalent required
Associate degree in healthcare, business administration, or related field preferred
Bachelor’s degree in healthcare or related field strongly preferred
Experience
Minimum of 3 years of experience in a healthcare medical staff credentialing environment preferred
Experience supporting accreditation surveys and regulatory reviews
Strong data entry, reporting, and document management experience
Proficiency in Microsoft Office and electronic credentialing systems
Working knowledge of medical terminology and healthcare office procedures
Licensure / Certification
Certified Provider Credentialing Specialist (CPCS) preferred
Willingness to obtain CPCS certification within one year of hire if not already certified
High attention to detail and accuracy
Ability to manage large volumes of complex information
Strong written and verbal communication skills
Professional judgment when handling confidential and sensitive information
Ability to build effective working relationships with physicians, NPs, PAs, and allied health professionals
Strong organizational skills with the ability to meet deadlines in a regulated environment
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