Credentialing Specialist - Medical Staff Affairs

We are seeking a highly organized and knowledgeable Medical Staff Coordinator to oversee the operations of the Medical Staff Affairs office. This role plays a critical part in supporting credentialing and recredentialing processes in collaboration with the Central Verification Organization (CVO), managing medical staff meetings, and ensuring compliance with regulatory and accreditation standards. The coordinator serves as a key resource for medical staff, hospital administration, and legal counsel, maintaining confidentiality and promoting consistent, high-quality support across all medical staff functions.

Responsibilities

Coordinate and oversee the Medical Staff Affairs office operations; Collaborate with the CVO on credentialing and recredentialing processes; Manage medical staff meetings and ensure accurate flow of information from committees to the Medical Executive Committee and Board of Trustees; Respond to verification requests and maintain accurate records; Serve as a resource for medical staff regarding bylaws, policies, and regulatory standards; Ensure compliance with accrediting bodies such as Joint Commission, NCQA, URAC, and HFAP; Maintain working knowledge of relevant statutes and laws; Coordinate annual medical staff projects and perform related bookkeeping activities; Communicate regularly with physician quality teams, medical staff leaders, hospital administration, and legal counsel; Maintain confidentiality of all medical staff and business-related information; Support departmental performance and teamwork; Interpret, explain and follow all regulatory guidelines, including medical staff bylaws, rules and regulations and policies; Credentialing initial and reappointment applications to meet regulatory and department standards and deadlines

Requirements

High School Diploma required; One (1) year of credentialing, provider enrollment, or background/verification specialist experience required; Working knowledge of State and Federal law relating to due process and the Health Insurance Portability and Accountability Act of 1996 and all applicable standards; High level of energy to work in a fast paced environment often including time deadlines, frequent interruptions, multiple demands and multi-tasking; Strong understanding of medical staff credentialing and regulatory requirements; Experience with accreditation standards (e.g., Joint Commission, NCQA, URAC, HFAP); Excellent organizational, communication, and interpersonal skills; Ability to manage multiple priorities and maintain confidentiality; Proficiency in interpreting and applying medical staff bylaws, rules, and policies

Nice to have

Associate's Degree; Prior experience in a healthcare or hospital setting