Credentialing Specialist

We are looking for a Credentialing Specialist to support credentialing and privileging activities for physician staff in Santa Monica, California. This Credentialing Specialist plays an important role in maintaining accurate provider records, supporting compliance efforts, and coordinating documentation for appointment and reappointment workflows. The ideal candidate brings prior experience in a hospital or healthcare environment, strong working knowledge of MD Staff, and the ability to manage sensitive information with accuracy and care.

Key Responsibilities:

Oversee the end‑to‑end credentialing cycle for physicians within an MSO‑supported, multi‑site environment, including new appointments, renewals, and ongoing provider status maintenance.

Review and validate provider documentation such as licenses, education, certifications, employment history, references, and malpractice coverage, ensuring alignment with MSO, payer, and organizational standards.

Administer privilege requests and updates by tracking clinical privileges across affiliated practices and service locations, ensuring consistency with governing bylaws, MSO policies, and medical staff requirements.

Maintain complete, accurate, and current practitioner files within the MD Staff platform, supporting MSO credentialing operations, data integrity, and audit readiness.

Track expiring credentials and proactively follow up to obtain renewed licenses, certifications, and supporting documentation needed for MSO participation and payer enrollment continuity.

Assemble credentialing and re‑credentialing packets for review by medical staff committees, leadership groups, and MSO governance bodies.

Support compliance with Joint Commission, NCQA, CMS, and MSO‑specific accreditation and regulatory standards.

Serve as a primary point of contact for physicians, department leaders, MSO stakeholders, and affiliated practices regarding application status, missing items, and approval timelines.

Contribute to audits, survey preparation, policy updates, and process improvement initiatives related to MSO credentialing, provider enrollment, and medical staff services.

Benefits:

Medical, Dental and Vision Insurance. 401K Retirement, Sick Time Off and Tuition Reimbursement.