Position Summary:
The Credentialing Specialist plays a critical role in maintaining compliance and accuracy in credentialing processes for medical staff and providers. This includes initial appointments, reappointments, clinical privileging, and credentialing audits in alignment with internal policies, hospital bylaws, and external regulatory requirements.
Responsibilities:
Manage end-to-end provider credentialing and re-credentialing processes
Complete and maintain license renewals prior to expiration
Conduct primary source verification for new and existing providers
Maintain and update provider files and credentialing records
Utilize MDStaff or similar credentialing software for data management and reporting
Ensure database consistency, accuracy, and compliance with credentialing standards
Interpret and apply regulatory requirements from accrediting bodies
Provide back-up support to credentialing team members as needed
Perform periodic credentialing audits to ensure data integrity and compliance
Bachelor’s Degree – Required
Healthcare field experience – Required
Familiarity with credentialing databases and software (e.g., MDStaff)
Knowledge of regulatory and accreditation standards related to credentialing
Strong organizational and auditing skills
High attention to detail and data accuracy