Medical Privileging Specialist - Remote

Overview

The Privileging Specialist verifies the qualifications, licenses, and experience of healthcare providers to grant authority for specific medical acts within a facility, ensuring compliance with regulatory and organizational standards. This Specialist will manage the full lifecycle of provider onboarding, including application processing, background checks, and will maintain accurate records for accreditation.

In Short

• Verify education, training, work history, board certifications, and licensure for doctors and APPs.
• Manage the appointment, reappointment, and delineation of clinical privileges of doctors and APPs.
• Ensure adherence to NCQA, JCAHO, state and federal standards.
• Maintain and update detailed provider records in credentialing database(s).
• Act as liaison, and communicate with providers, medical staff offices and licensing boards.
• Help coordinate and obtain peer to peer references.
• Submit and maintain applications submitted to facilities.
• Maintain and update databases for facilities and practitioners.
• Collaborate with internal teams to ensure smooth transition for new practices and providers.
• Track status of activities and provide updates to internal departments.

Requirements

• High School Diploma or equivalent, associate or bachelor’s degree preferred.
• 3+ years in the healthcare industry.
• Compliance with all HIPAA policies.
• Microsoft Office experience (Excel, Word, Outlook, PowerPoint).
• Excellent organization and communication skills.
• Handle multiple projects simultaneously in a fast-paced environment.
• Satisfactory criminal background check.

Benefits

• Equal Opportunity Employer committed to diversity and inclusion.