Medical Staff Specialist

Medical Staff Specialist

Part Time Remote

Position Summary

The Medical Staff Specialist is responsible for managing provider credentialing, licensing, privileging, and onboarding activities across the organization. This position supports ensuring provider records remain accurate, complete, current, and compliant.

The role works closely with the Payor Relations team, Director of Compliance, providers, and practice leadership to support credentialing, enrollment, regulatory compliance, and operational needs.

Key Responsibilities

Provider Credentialing & Revenue Cycle

• Maintain provider information and documentation within CredentialStream.
• Maintain organized backup credentialing files, including:
  • State professional licenses
  • Anesthesia permits
  • DEA registrations
  • Controlled substance registrations
  • Malpractice Certificates of Insurance (COIs)
  • Board certifications
  • CVs
  • Education and training documentation
• Monitor license, permit, certification, and registration expiration dates.
• Coordinate with providers and practice leadership to obtain timely renewals and updated documentation.
• Complete provider credentialing applications and obtain required Primary Source Verifications (PSVs).
• Identify credentialing discrepancies or potential "red flag" items and coordinate appropriate follow-up.
• Prepare completed credentialing files for Clinical Governance Board (CGB) review and privileging.
• Manage:
  • Initial appointment credentialing
  • Reappointment credentialing every three years
• Partner with Payor Relations and Compliance to ensure provider information is readily available for payor enrollment and delegated credentialing requirements.
• Support audits and maintain credentialing files in an audit-ready state.

Licensing, Privileging & Operations

• Coordinate professional license and registration renewals.
• Maintain Power of Attorney documentation, as applicable, for DEA and controlled substance registrations.
• Apply for and maintain provider hospital privileges.
• Coordinate credentialing and regulatory requirements for:
  • New provider onboarding
  • Resident onboarding
  • Fellow onboarding
• Assist providers, residents, and fellows with obtaining applicable licenses, registrations, permits, and hospital privileges.
• Coordinate and maintain Peer Review documentation and processes.
• Track and maintain applicable provider Continuing Education (CE) documentation.
• Auditing existing credentialing files for completeness and compliance.
• Obtaining missing documentation and correcting identified deficiencies.
• Establishing accurate and sustainable tracking processes for credentialing, licensing, and renewal requirements.

Qualifications

• Experience in medical staff services, provider credentialing, payor enrollment, healthcare administration, or a related field preferred.
• Knowledge of credentialing, privileging, licensing, CAQH, DEA, and primary source verification processes preferred.
• Experience with CredentialStream or another credentialing management system preferred.
• Strong organizational skills and attention to detail.
• Ability to manage multiple providers, deadlines, renewals, and credentialing cycles simultaneously.
• Strong written and verbal communication skills.
• Ability to work collaboratively with providers, leadership, Compliance, Revenue Cycle, and operational teams.
• Ability to handle confidential provider information with professionalism and discretion.

Preferred Experience

• Medical Staff Services or Credentialing Specialist experience
• Delegated credentialing and/or payor enrollment experience
• Hospital privileging experience
• Multi-site or multi-state healthcare organization experience
• Experience supporting physician or dental/oral surgery practices