Medical Staff Credentialing Specialist and Coordinator Job at Orleans Community Health (Medina)

Credentialing Specialist II-Medical Staff

Performs and monitors all credentialing functions, including complex credentiali...

Location

United States , Tucson

Salary:

Not provided

Tucson Medical Center

Expiration Date

Until further notice

Requirements

High school diploma or general education degree (GED)
Two (2) to Four (4) years of medical staff privileging or credentialing experience
CPCS or CPMSM certification preferred
Intermediate to Advanced Knowledge of healthcare practices and procedures
Advanced Skills in maintaining a detailed database, creating reports, and maintaining files
Intermediate to Advanced Ability to read, analyze, and interpret general business periodicals, professional journals, technical and software related procedures and manuals, governmental regulations
Display promotes and inspires trust and confidence among team members and stakeholders through reliability, authenticity, and accountability
Expresses thoughts clearly, concisely, and effectively both verbally and in writing
Establishes and maintains productive and cooperative relationships with team members, peers, management, and stakeholders both internal and external to the organization
Intermediate to Advanced ability to effectively present information and respond to inquiries regarding any issue related to the Credentialing and Privileging process

Job Responsibility

Performs and monitors all credentialing functions, including complex credentialing issues and brings forward issues to the Medical Staff Credentialing Lead and/or Director
Interfaces with senior medical staff leaders and administration and presents information when necessary
Utilizes knowledge of bylaws, rules, and regulations, expertise, sound judgment to mentor and support Medical Staff Credentialing Specialists I, other peers, and leadership
Acts as a liaison between Administration and members of the Medical Staff
Apply knowledge, expertise, sound judgment and consult other references and resources as necessary to generate and evaluate solutions and recommendations
Applies knowledge of bylaws, rules, and regulations to effectively serve as a Medical Staff information resource, to ensure timely flow of work, and sound judgment to mentor and support Medical Staff Credentialing Specialists I, other peers, and leadership
Ensures compliance with all applicable Accreditation agencies
Supports oversite and participate in internal, external, compliance surveys, reviews and audits as required
Utilizes credentialing software for new and reappointment letters, resignations, leave of absences, changes in staff category, add/delete privileges
Coordinates, monitors and maintains the credentialing and recredentialing process

Fulltime

Coordinator - Credentialing and Enrollment

Coordinator - Credentialing and Enrollment FT Days position at Carolinas Medical...

Location

United States , Charlotte

Salary:

24.10 - 36.15 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

High School Diploma or GED required
Bachelor's Degree preferred
Certification by National Association Medical Staff Services or Certified Provider Credentialing Specialists preferred
Previous experience as a Credentialing Coordinator preferred
Knowledge of The Joint Commission standards for hospitals and Behavioral Health Centers preferred

Job Responsibility

Processes and submits complete, timely and accurate applications to chief(s) of the appropriate department(s) for review and recommendation to the Facility Credentials Committees and communicates the status of credentialing applications to all constituents directly
Interprets and assists in implementing the standards of The Joint Commission
Prepares the maintenance documentation, as defined on the Delineation of Privileges Forms, for presentation to the Facility Credentials Committees at the time of reappointment
Processes requests and prepares correspondence to appointees regarding change of status, expansion of privileges (either an increase or a decrease), and resignations. Maintains and updates database accordingly
Serves as the first contact when communicating with hospital personnel regarding appointees clinical privileges and if they are allowed to go forward with cases, as scheduled
Prepares the appointees credentials files for audits
Maintains current licensure, certifications, malpractice insurance and any other applicable regulatory items at time of appointment and continuous maintenance going forward to ensure timeliness, accuracy and integrity of the credentialing and clinical privileging database system and compliance with the regulatory agencies

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program

Fulltime

Credentialing Specialist

We are seeking a Credentialing Specialist for a short term contract in Nashville...

Location

United States , Nashville

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

High school diploma or equivalent (Associate’s or Bachelor’s degree in Healthcare Administration or related field preferred)
1–3 years of experience in healthcare credentialing, provider enrollment, or medical staff services
Knowledge of payer enrollment processes (Medicare, Medicaid, commercial payers)
Familiarity with credentialing standards and regulatory requirements
Proficiency with credentialing software, provider databases, and Microsoft Office (Excel, Word, Outlook)
Strong organizational skills with high attention to detail
Excellent written and verbal communication skills

Job Responsibility

Coordinate and process initial credentialing, recredentialing, and payer enrollment for healthcare providers
Collect, verify, and maintain provider documentation including licenses, certifications, education, training, work history, NPIs, and DEA registrations
Prepare and submit credentialing and enrollment applications to insurance payers, hospitals, and regulatory bodies
Monitor credential expirations and proactively manage renewals to maintain continuous provider eligibility
Maintain accurate and up‑to‑date credentialing records in credentialing software and internal databases
Serve as a liaison between providers, payers, medical staff offices, and internal departments
Track application statuses, follow up on outstanding items, and resolve credentialing or enrollment issues
Ensure compliance with CMS, NCQA, Joint Commission, state, and payer credentialing requirements
Support audits and accreditation reviews by preparing and providing credentialing documentation
Maintain strict confidentiality of sensitive provider information

What we offer

medical
vision
dental
life and disability insurance
401(k) plan

Coordinator Credentialing Senior

The Coordinator Credentialing Senior serves as the first line of defense through...

Location

United States , Irving

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

High School Diploma required
3 Years Related Experience preferred
Certified Provider Credentialing Specialist (CPCS) or Certified Medical Staff Coordinator (CMSC) preferred

Job Responsibility

Responsible for all aspects of credentialing
Serves as role model and mentor to others in interfacing relevant roles
Preceptor to others in duties related to credentialing
Cross trains other staff for major job responsibilities as appropriate for optimum functioning
Serves as liaison between staff and administration
Oversees credentialing activities
Precepts and mentors designated staff personnel
Coordinates staff with regulators
May facilitate staff meetings
May be responsible for the preparation of meetings, including production of agenda, documents for review and for personal review and preparation of staff in advance, as needed to facilitate informed participation

Fulltime

Credentialing Specialist

The Credentialing Specialist is responsible for supporting the credentialing, re...

Location

United States , West Hollywood

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Experience in healthcare administration, credentialing, provider enrollment, or medical staff services preferred
Familiarity with provider credentialing, compliance, or payer enrollment processes is a plus
Strong attention to detail and ability to manage multiple deadlines and tracking requirements
Proficiency with Microsoft Office Suite, especially Excel
Experience using credentialing or healthcare systems/databases preferred
Strong written and verbal communication skills
Ability to handle confidential and sensitive information with discretion
Knowledge of HIPAA, regulatory standards, and healthcare documentation practices preferred
Certification (e.g., CPCS, CPMSM) is a plus but not required

Job Responsibility

Coordinate and manage initial credentialing and re‑credentialing for healthcare providers
Collect, review, and maintain provider documentation (licenses, certifications, education, work history, malpractice coverage, etc.)
Perform primary source verification in accordance with regulatory and organizational standards
Track license, certification, and enrollment expiration dates to ensure ongoing compliance
Maintain accurate provider records within credentialing databases and internal systems
Communicate with providers and internal stakeholders regarding application status and missing documentation
Assist with payer enrollment and revalidation processes, as assigned
Support audits and ensure credentialing files are complete and compliant
Maintain confidentiality and comply with HIPAA and regulatory requirements
Perform additional administrative or credentialing support duties as needed

What we offer

Medical, Dental and Vision Insurance
401K Retirement
Sick Time Off
Tuition Reimbursement
medical, vision, dental, and life and disability insurance
company 401(k) plan

Credentialing Specialist

The Credentialing Specialist is responsible for supporting the credentialing, re...

Location

United States , West Hollywood

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Experience in healthcare administration, credentialing, provider enrollment, or medical staff services preferred
Familiarity with provider credentialing, compliance, or payer enrollment processes is a plus
Strong attention to detail and ability to manage multiple deadlines and tracking requirements
Proficiency with Microsoft Office Suite, especially Excel
Experience using credentialing or healthcare systems/databases preferred
Strong written and verbal communication skills
Ability to handle confidential and sensitive information with discretion
Knowledge of HIPAA, regulatory standards, and healthcare documentation practices preferred
Certification (e.g., CPCS, CPMSM) is a plus but not required

Job Responsibility

Coordinate and manage initial credentialing and re‑credentialing for healthcare providers
Collect, review, and maintain provider documentation (licenses, certifications, education, work history, malpractice coverage, etc.)
Perform primary source verification in accordance with regulatory and organizational standards
Track license, certification, and enrollment expiration dates to ensure ongoing compliance
Maintain accurate provider records within credentialing databases and internal systems
Communicate with providers and internal stakeholders regarding application status and missing documentation
Assist with payer enrollment and revalidation processes, as assigned
Support audits and ensure credentialing files are complete and compliant
Maintain confidentiality and comply with HIPAA and regulatory requirements
Perform additional administrative or credentialing support duties as needed

What we offer

Medical, Dental and Vision Insurance
401K Retirement
Sick Time Off
Tuition Reimbursement

Credentialing Coordinator III

Participates in departmental activities to ensure quality in conducting, maintai...

Location

United States of America , Rochester

Salary:

23.06 - 32.29 USD / Hour

University of Rochester

Expiration Date

Until further notice

Requirements

Associate's degree in business or healthcare related field and 2 years of medical administrative experience required
Or equivalent combination of education and experience
1 year of medical credentialing and/or payer enrollment experience preferred
Fluent English language skills (oral and written) required
Proficiency in MS Office (e.g. Word, Excel, and PowerPoint), email, internet required
Knowledge of and experience with Joint Commission, CMS, and NCQA Regulations related to medical staff services and Commercial Payers Credentialing preferred
Knowledge of and experience with database applications preferred
Exceptional interpersonal and communication skills preferred
Ability to develop and maintain relationships with a variety of key stakeholders across the organization preferred
Certified Medical Professional Services Management (CPMSM) upon hire preferred

Job Responsibility

Determines practitioner eligibility for membership/participation
Analyzes application and supporting documents for accuracy and completeness and informs the practitioner of the application status
Obtains, researches, and evaluates information from primary sources to ensure compliance with accreditation and regulatory standards
Recognizes, investigates, and validates discrepancies and adverse information obtained during the application process
Processes requests for privileges when applicable
Monitors the initial and reappointment process for all Medical and Allied Health Professional staff
Monitors the status of completed files in departmental review and/or committee review until final approval
Monitors personal performance statistics related to accuracy and productivity
Reviews performance measures and goals with auditors and management regularly
Collaborates and coordinates activities with the Credentialing Managers and staff

Fulltime

Supervisor Medical Staff Services

Leads, plans, organizes and is responsible for the day to day operations of the ...

Location

United States

Salary:

30.70 - 46.05 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Credentialing Specialist, Certified Provider (CPCS) issued by the National Association Medical Staff Services (NAMSS), or Medical Services Management, Certified Professional (CPMSM) issued by the National Association Medical Staff Services (NAMSS)
Bachelor's Degree in Health Care Administration or related field
Typically requires 3 years of experience in medical staff services, credentialing, physician relations, regulatory, with experience as a lead or senior level staff
Excellent interpersonal and communication skills including both verbal and written
Ability to use of variety of software and credentialing database
Demonstrated time management and task delegation skills
Ability to work as a team member in a fast paced environment with multiple tasks requiring completion within short timeframes
Position requires high degree of judgment and ability to think independently

Job Responsibility

Implements, coordinates, monitors, and maintains effective credentialing processes for the process of appointment, reappointment and credentialing for the designated medical staff organizations
Serves as resource person on credentialing/privileging, bylaws, policies governing medical practice, and other related matters to the medical staff
Assists in the development and implementation of medical staff policies and procedures as needed and updates as appropriate relating to credentialing
Provides support regarding issues involving Medical Staff Professionalism including wellness, corrective action and fair hearing processes
Provides accurate and timely reports to the medical staff, governing council and system governing board regarding all aspects of the credentialing and privileging process including any related reports
Develops and implements departmental workflows, policies and procedures, standards of practice, manuals, forms, etc., as needed and updates as appropriate
Manages operations of the Medical Staff Services Department and provides oversight and direction to staff
Performs human resources responsibilities for staff which includes coaching on performance, completes performance reviews and overall staff morale
Responsible for understanding and adhering to the organization's Code of Ethical Conduct and for ensuring that personal actions, and the actions of employees supervised, comply with the policies, regulations and laws applicable to the organization's business

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program

Fulltime

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Medical Staff Credentialing Specialist and Coordinator

Job Description

Job Responsibility

Requirements

What we offer

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