Credentialing Specialist

COMPANY OVERVIEW

Northern Light Medical Management is a physician‑led, patient‑centered healthcare organization committed to delivering high‑quality, accessible, and innovative care across our network of medical practices. We prioritize clinical excellence, operational efficiency, and a culture of accountability, ensuring the highest standards of patient safety and outcomes. Our organization adheres to all federal, state, and accreditation standards, including those established by The Joint Commission, to maintain a safe and compliant care environment.

The Medical Staff Coordinator/Credentialing Specialist plays a critical role in ensuring the integrity, accuracy, and compliance of the organization’s credentialing and privileging processes. This position supports the onboarding and ongoing compliance of physicians and allied health professionals by managing credentialing workflows, maintaining regulatory standards, and serving as a key liaison between providers, leadership, and regulatory bodies.

• Manage the full‑cycle credentialing and privileging process for radiologists, including primary source verification of licenses, reappointments, and changes in privileges.
• Maintain accurate, up‑to‑date records for all radiologists, including licensure, certifications, and training.
• Ensure all credentialing files are complete, accurate, and audit‑ready.
• Maintain compliance with all applicable regulatory and accreditation standards, including federal, state, and The Joint Commission requirements.
• Stay current on changes in credentialing regulations, payer requirements, and industry best practices.
• Support internal and external audits, ensuring documentation and processes meet compliance expectations.
• Maintain and update credentialing databases, ensuring data integrity and timely entry of all provider information.
• Track key metrics such as credentialing timelines, expirables, and compliance rates.
• Serve as a primary point of contact for physicians and medical staff regarding credentialing inquiries.
• Communicate effectively with providers, internal departments, and external agencies to resolve issues and ensure smooth processing.
• Serve as a liaison between physicians and hospital administration.
• Collaborate with HR, Compliance, and Operations to support a seamless provider lifecycle.
• Participate in quality assurance initiatives and continuous improvement efforts.
• Stay informed on industry trends and best practices in medical staff credentialing.

• Experience in healthcare administration, preferably in a hospital or multi‑specialty setting.
• Demonstrated experience in credentialing, medical staff services, and/or provider licensing.
• Working knowledge of credentialing platforms and systems, including Federation of State Medical Boards (FSMB), Interstate Medical Licensure Compact (IMLC), and CAQH.
• Strong understanding of accreditation standards and regulatory requirements.
• Strong interpersonal skills and the ability to work effectively in a team‑oriented environment.
• Ability to manage multiple priorities in a fast‑paced environment.
• Proficiency in Microsoft Office 365 and credentialing software systems.
• Ability to work both independently and collaboratively.
• Strong written and verbal communication skills, attention to detail.

• Adhere to all federal, state, and local healthcare regulations governing credentialing, licensing, and medical staff services.
• Ensure compliance with accreditation bodies such as The Joint Commission.
• Maintain strict confidentiality and protect sensitive provider and organizational data in accordance with HIPAA and company policies.
• Support audit readiness and participate in regulatory reviews as required.