Credential Specialist II

Job description

Job Summary: The Credentialing Specialist II is responsible for managing the end-to-end credentialing and privileging process for physicians across a multi-state hospital system. This mid-level role requires strong knowledge of regulatory requirements and the ability to work independently while ensuring compliance with state-specific regulations, accreditation standards, and organizational policies. The specialist collaborates with medical staff leadership, providers, and administrative teams to ensure timely and accurate credentialing operations. Job Responsibilities/Duties: Key Responsibilities - Manage full-cycle credentialing and recredentialing processes for physicians across multiple hospital locations and states to ensure compliance with payors. - Perform thorough primary source verification of licensure, board certifications, education, training, work history, and malpractice coverage - Ensure compliance with federal, state-specific, and accreditation standards (e.g., Joint Commission, NCQA, CMS) across all facilities - Maintain and update provider credentialing files and databases with a high degree of accuracy - Monitor and track expiration dates for licenses, certificati...