Credentialing Specialist at Northern… · Hollywood

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.

POSITION SUMMARY:

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.

This role is essential to enabling timely provider onboarding, safeguarding patient care standards, and supporting organizational growth through efficient and compliant medical staff operations.

RESPONSIBILITIES & DUTIES:

• Manage the full-cycle credentialing and privileging process for radiologist, 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.

QUALIFICATIONS & SKILLS:

• 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 (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, interpersonal, and attention to detail.

REGULATORY & COMPLIANCE EXPECTATIONS:

• 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.

PHYSICAL REQUIREMENTS:

• Ability to sit or stand for extended periods
• Visual acuity sufficient to interpret detailed diagnostic images
• Manual dexterity to operate computer systems and imaging software
• Ability to communicate effectively with patients, providers, and staff
• Occasional movement throughout clinical and office environments

WHAT WE OFFER:

At Northern Light, we believe our people are our greatest asset. We are committed to providing a comprehensive and competitive benefits package that supports your health, financial well-being, and professional growth:

• Comprehensive Health Coverage – Medical, dental, vision insurance plans designed to support you and your family
• Retirement Planning – 401(k) plan with company support to help you build long-term financial security
• Voluntary Benefits – Access to supplemental plans including life, disability, and other optional coverage
• Generous Paid Time Off – PTO, holidays, and flexible time to recharge and maintain work-life balance
• Professional Development – Ongoing training, certification support, and career growth opportunities
• Collaborative Culture – A mission-driven organization focused on innovation, teamwork, and excellence in patient care
• Stability & Growth – Opportunity to grow within a rapidly evolving healthcare organization

This job description is intended to describe the general nature and level of work performed by an individual in this position. It is not intended to be an exhaustive list of all responsibilities, duties, or qualifications required. Duties and responsibilities may be modified at any time based on organizational needs. In accordance with the Americans with Disabilities Act (ADA) and applicable state and local laws, reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position.

Northern Light Medical Management is committed to compliance with all applicable federal, state, and local laws and regulations, as well as accreditation standards established by The Joint Commission. This includes, but is not limited to, regulations related to patient safety, workplace safety, equal employment opportunity, non-discrimination, and privacy and confidentiality of protected health information under Health Insurance Portability and Accountability Act (HIPAA). Employees are expected to perform all duties in a manner consistent with these standards and to participate in ongoing training, competency assessments, and compliance activities as required.