Medical Staff Credentialing Specialist

Beth Israel Lahey Health; Woburn (MA); On-site; USD 44,000 - 58,000; Full time

Job summary

Beth Israel Lahey Health in Massachusetts is seeking a Credentialing Specialist to independently manage provider credentialing for initial appointment and reappointment, including primary source verification and data integrity.

You will maintain audit-ready files, ensure timely completion, and communicate status with leadership while adhering to Joint Commission, NCQA, and DNV standards.

Qualifications

• Minimum 1–3 years of healthcare administration, medical staff services, credentialing, provider enrollment or related experience; 2 years in a hospital MSO or CVO environment preferred.
• NAMSS CPCS certification preferred.
• Working knowledge of Joint Commission, DNV, CMS, NCQA, and state regulations.

Responsibilities

• Independently manages credentialing applications for initial appointment and reappointment, including intake, primary source verification, analysis, and ongoing status management.
• Performs primary source verification activities and analyzes data for accuracy, completeness, and regulatory compliance.
• Identifies red flags and escalates issues to leadership for review and resolution.
• Maintains audit-ready electronic credentialing files ensuring data integrity and compliance with standards.
• Ensures timely and accurate file completion per turnaround time and service level standards.
• Prepares files for internal quality review, peer audits, and committee submission.
• Participates in peer audits and quality improvement activities.
• Communicates effectively with leadership and stakeholders regarding status and barriers.

Skills

Detail orientation

Organizational skills

Time management

Communication skills

Customer service

Independence

Analytical thinking

Education

High School Diploma or equivalent

Associate’s or Bachelor’s degree preferred

NAMSS CPCS certification preferred

Tools

Credentialing databases

Electronic systems

Office software

Job description

Beth Israel Lahey Health in Massachusetts is seeking a Credentialing Specialist to independently manage provider credentialing for initial appointment and reappointment, including primary source verification and data integrity.

You will maintain audit-ready files, ensure timely completion, and communicate status with leadership while adhering to Joint Commission, NCQA, and DNV standards.