Credentialing Specialist

OneOncology

13d•Remote

About The Position

The Credentialing Specialist reports to OneOncology’s Credentialing Manager and is responsible for all aspects of privileging and credentialing for physicians and allied health professionals. The role processes applications, verifies information, researches application details, and ensures procedures comply with medical staff requirements. It provides consistent, accurate, and timely credentialing support, including documented verification of application information and maintenance of highly confidential credentialing files. The position is remote, with travel flexibility as needed.

Requirements

High school diploma.
At least 2 years of related experience.
Industry experience leading credentialing activities in a large provider practice or across multiple practices.
Proficiency with Microsoft Office Suite, including Word and Excel, and web-based applications.
Ability to communicate verbally and in writing while maintaining confidentiality.
Strong attention to detail and organizational skills.
Excellent interpersonal skills and ability to work as a team player.
Ability to prioritize multiple responsibilities, manage a large workload under tight deadlines, work well under pressure, adapt to change, and perform in a productivity-based environment.
Excellent verbal and written communication skills.
Research and problem-solving skills.
Ability to work remotely and travel as needed.

Nice To Haves

Bachelor’s degree preferred.
Training experience preferred but not required.
Certifications preferred but not required.

Responsibilities

Credential and re-credential physicians and allied health professionals.
Complete, submit, and track credentialing applications with managed care organizations and hospitals.
Apply for and validate hospital privileges.
Obtain malpractice insurance policies.
Notify staff when credentialing is complete so scheduling and billing can proceed.
Maintain and update providers’ CAQH online credentialing applications quarterly.
Manage credentialing databases and provider files, maintaining vital credentialing information in technology tools and hard-copy documents on the OneOncology platform.
Track and maintain clinical licenses for nursing, pharmacy, and laboratory personnel.
Track continuing education credits for providers, notify them of deficiencies, and submit documentation when providers are audited.
Upon a physician’s or allied health professional’s termination, contact managed care organizations, hospitals, and EMR systems to remove the provider within 30 days.