Credentialing Specialist, Professional Staff Affairs

Medical Billing and CodingMedical Billing and CodingFull TimeRemoteTeam 10,001+H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

6 days ago

Salary

Not specified

Credentialing SoftwareMicrosoft OfficeJoint Commission StandardsCMS RegulationsNCQA StandardsMA DPH Regulations

Job Description

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.

Role Description

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives. The Credentialing Specialist, Professional Staff Affairs, will support the Office of Professional Staff Affairs at Beth Israel Deaconess Medical Center in Boston, MA. Once trained, this role can work remotely. Incumbent will begin training on an 8am - 4:30pm schedule, with some flexibility after trained to start earlier if preferred.

Beth Israel Lahey Health and the BIDMC Office of Professional Staff Affairs are devoted to consistently promoting a culture of Wellbeing, Empathy, Collaboration, Accountability, Respect, and Equity as outlined in our organization's WE CARE values.

In this role, you will ensure accurate, reliable, and compliant credentialing, privileging, and peer review processes for medical staff. This role supports regulatory readiness, data integrity, and professional practice evaluation in alignment with Joint Commission, CMS, MA DPH, NCQA, and payer requirements.

This position demands exceptional attention to detail and a commitment to high reliability in managing complex privileging requirements across 13 clinical departments and approximately 60 divisions. It encompasses multiple high-acuity programs and specialized disease centers, ensuring full compliance with diverse regulatory standards and program-specific requirements.

The Specialist plays a critical role in supporting various medical staff leaders and committees throughout the credentialing and privileging decision-making process by identifying red flags in credentials files, ensuring accurate presentation of information, and validating completeness of reviewer feedback.

Qualifications

  • High School diploma or GED required; Bachelor’s degree preferred.
  • 3–5 years of related work experience in credentialing or medical staff services.
  • Strong organizational skills, attention to detail, and ability to prioritize workload.
  • Proficiency with credentialing software (e.g., Cactus) and Microsoft Office applications (Outlook, Word, Excel, PowerPoint).
  • Working knowledge of regulatory and accreditation standards (Joint Commission, CMS, MA DPH, NCQA).
  • Ability to interpret and apply complex privileging requirements.

Requirements

  • Certification from the National Association of Medical Staff Services (CPCS or CPMSM) preferred.
  • Experience supporting delegated credentialing audits and payer compliance.
  • Experience with credentialing for complex privileging structures and high-acuity programs (e.g., trauma, transplant, disease-specific certifications) strongly preferred.
  • Experience working in a high-reliability healthcare environment.

Benefits

  • Consistently promote a culture of Wellbeing, Empathy, Collaboration, Accountability, Respect, and Equity as outlined in the organization's WE CARE values.
  • Demonstrated commitment and actions to valuing diversity and contributing to an inclusive working and learning environment.
  • This is a remote position but may require occasional on-site presence for meetings, etc.
  • Sedentary work: May exert up to 10 pounds of force occasionally in carrying, lifting, pushing, pulling objects. Sitting most of the time, with walking and standing required only occasionally.

Company Description

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues, and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment.

More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.

Equal Opportunity Employer/Veterans/Disabled

Job Requirements

  • High School diploma or GED required; Bachelor’s degree preferred.
  • 3–5 years of related work experience in credentialing or medical staff services.
  • Strong organizational skills, attention to detail, and ability to prioritize workload.
  • Proficiency with credentialing software (e.g., Cactus) and Microsoft Office applications (Outlook, Word, Excel, PowerPoint).
  • Working knowledge of regulatory and accreditation standards (Joint Commission, CMS, MA DPH, NCQA).
  • Ability to interpret and apply complex privileging requirements.
  • Certification from the National Association of Medical Staff Services (CPCS or CPMSM) preferred.
  • Experience supporting delegated credentialing audits and payer compliance.
  • Experience with credentialing for complex privileging structures and high-acuity programs (e.g., trauma, transplant, disease-specific certifications) strongly preferred.
  • Experience working in a high-reliability healthcare environment.

Benefits

  • Consistently promote a culture of Wellbeing, Empathy, Collaboration, Accountability, Respect, and Equity as outlined in the organization's WE CARE values.
  • Demonstrated commitment and actions to valuing diversity and contributing to an inclusive working and learning environment.
  • This is a remote position but may require occasional on-site presence for meetings, etc.
  • Sedentary work: May exert up to 10 pounds of force occasionally in carrying, lifting, pushing, pulling objects. Sitting most of the time, with walking and standing required only occasionally.

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