Credentialing Specialist
Henry Ford Health
At Henry Ford Health, we're committed to advancing health and improving lives for the millions of people we serve across Michigan and around the world. As one of the nation's leading academic health systems, we provide a comprehensive continuum of care that includes primary and preventive services, specialty and complex care, virtual care, pharmacy, home health, eye care, health insurance, and more. With 12 hospitals and hundreds of ambulatory care locations, including former Ascension Southeast Michigan and Flint Region facilities, our growing network expands access to exceptional care in the communities we serve.
Headquartered in Detroit, Henry Ford Health is helping shape the future of healthcare through the transformative Future of Health: Detroit initiative, a $3 billion investment that is redefining our academic healthcare campus and advancing innovation, research, education, and community impact. Our work is grounded in purpose, collaboration, and belonging. We empower team members to grow their careers, contribute innovative ideas, and make a meaningful difference every day. Whether you're caring for patients, supporting operations, conducting research, or driving new solutions, you'll be part of a team united by a shared mission: delivering exceptional care, advancing health outcomes, and building healthier communities for all.Job Description
GENERAL SUMMARY :
As a Credentialing Specialist, you'll play a vital role in our medical staff services team, ensuring that healthcare practitioners meet the highest standards of qualification and compliance. Under general supervision, you'll manage all credentialing and recredentialing functions for practitioner applicants, combining meticulous data management with strategic verification processes. Your work directly supports our commitment to patient safety and organizational excellence.
PRINCIAL DUTUES AND RESPONSIBILITIES :
- Drive the Credentialing Process Forward
- Manage end-to-end credentialing for medical staff and allied health professionals, including initial appointments, provisional reviews, reappointments, and privilege delineation
- Coordinate application processing with precision, ensuring all submissions are complete, accurate, and processed within established timelines
- Conduct thorough primary source verification of credentials, maintaining compliance with organizational policies and regulatory requirements
- Proactively track responses and follow up on outstanding items, keeping the process moving efficiently
- Maintain Data Integrity and Accuracy
- Manage credentialing software databases with meticulous attention to detail, ensuring all data is complete, current, and audit-ready
- Request and organize sensitive documentation including case logs, procedures, and confidential practitioner information
- Submit completed files to MSO offices and delegated entities in compliance with all requirements
- Build Strategic Partnerships
- Serve as a trusted liaison between Henry Ford Health System facilities and the Credentialing Services team
- Communicate clearly and professionally with internal and external stakeholders to facilitate information exchange and resolve inquiries
- Provide exceptional customer support aligned with corporate standards of excellence
- Ensure Regulatory Excellence
- Support compliance with accrediting and regulatory agencies including The Joint Commission, NCQA, URAC, and HFAP
- Develop and maintain working knowledge of relevant state and federal statutes and regulations
- Contribute to Continuous Improvement
- Participate actively in system integration and quality improvement initiatives
- Pursue professional development through industry organizations, seminars, and publications to stay current with medical staff services trends
- Perform additional duties as assigned to support organizational goals
Qualifications
EDUCATION/EXPERIENCE REQUIRED:
- High School Diploma required. Associate’s Degree, preferred.
- 1 year of credentialing, provider enrollment, or background/verification specialist experience required.
- High level of energy to work in a fast paced environment often including time deadlines, frequent interruptions, multiple demands and multi-tasking.
- Working knowledge of State and Federal law relating to due process and provisions of the Health Insurance Portability and Accountability Act if 1996 and all applicable standards.
Additional Information
PHYSICAL DEMANDS/WORKING CONDITIONS :
- Normal office environment with minimal exposure to noise, dust, or extreme temperatures.
- Must meet or exceed core customer service responsibilities, standards and behaviors as outlined in the HFHS’ Customer Service Policy
- Must practice the customer skills as provided through on-going training and in-services.
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