Medical Staff Credentialing Specialist

This is a fully remote position, open to applicants in Tennessee.

📋 Description

• Manage the processing of initial appointments, reappointments, and privileging applications for physicians and advanced practice providers in line with Medical Staff Bylaws, accreditation standards, and organizational policies.

• Conduct thorough primary source verification of licensure, education, training, board certification, work history, professional references, malpractice coverage, sanctions, and other credentialing prerequisites.

• Compile credentialing files for assessment by Medical Staff Services leadership, credentialing committees, Medical Executive Committees, and Governing Boards.

• Maintain provider credentialing records within MD-Staff and other credentialing systems, ensuring accuracy and adherence to regulatory standards.

• Work closely with Medical Staff Professionals, providers, facility leadership, and department stakeholders to gather necessary documentation and address credentialing deficiencies.

• Track provider expirables, including licenses, DEA registrations, board certifications, malpractice insurance, and other essential credentials to guarantee ongoing compliance.

• Assist in privileging activities, which include processing delineation of privileges forms and keeping provider privilege records up to date.

• Ensure adherence to Joint Commission, CMS, NCQA, state regulatory requirements, and Medical Staff Bylaws.

• Handle multiple credentialing files concurrently while meeting specified turnaround times and service level expectations.

• Engage in quality assurance activities, audits, and process improvement initiatives to enhance credentialing accuracy and operational efficiency.

⛳️ Requirements

• At least 2 years of experience in provider credentialing is required; experience in hospital Medical Staff credentialing is highly preferred.

• Proven experience credentialing physicians, advanced practice, or other licensed healthcare providers.

• Familiarity with performing primary source verification, reviewing provider files, and conducting credentialing compliance activities.

• Knowledge of Joint Commission, CMS, NCQA, and Medical Staff credentialing standards is preferred.

• Experience in supporting credentialing committees, Medical Executive Committees, privileging processes, or provider onboarding is preferred.

• Proficiency in using credentialing systems such as MD-Staff, CredentialStream, Cactus, Symplr, or similar credentialing platforms is preferred.

• Excellent organizational skills with the ability to handle multiple provider files and competing deadlines concurrently.

• Proven ability to work independently in a remote setting while maintaining productivity and quality standards.

🏝️ Benefits

• Comprehensive Benefits: Multiple levels of medical, dental, and vision coverage for both full-time and part-time employees.

• Financial Protection & PTO: Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave, and paid time off.

• Financial & Career Growth: Higher education and certification tuition assistance, loan assistance, and a 401(k) retirement plan with company matching.

• Employee Well-being: Mental, physical, and financial wellness programs, including free gym memberships, virtual care appointments, mental health services, and discount programs.

• Professional Development: Continuous learning and career advancement opportunities.