Credentialing Specialist

OneOncology

2d • Remote

About The Position

OneOncology is positioning community oncologists to drive the future of medical care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer and other diseases. Our team is bringing together leaders to the market place to help drive OneOncology’s mission and vision. This is an exciting time to join OneOncology. Our values-driven culture reflects our startup enthusiasm supported by industry leaders in oncology, urology, technology, and finance. We are looking for talented and highly-motivated individuals who demonstrate a natural desire to improve and build new processes that support the meaningful work of independent physicians and the patients they serve. The Credentialing Specialist will report to OneOncology’s Credentialing Manager. The credentialing specialist is responsible for all aspects of the privileging and credentialing process for physicians and allied health professionals. The Specialist will process applications, verify information, research application details, and assure processes are in accordance with medial staff procedures. The specialists will provide consistent, accurate, and timely credentialing support, enhancing the organizations ability to provide professional services. Work includes the accurate, timely and documented verification of the information provided by the application and maintenance of the highly confidential credentialing related files.

Requirements

• High school diploma and 2+ years of related experience.
• Industry experience leading credentialing activities in large provider practice (or multiple practices) is required

Nice To Haves

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

Responsibilities

• Credentialing and re-credentialing of physicians and allied health professionals
• Completion, submission and tracking of credentialing applications with all managed care organizations and hospitals.
• Apply and validate hospital privileges
• Obtain malpractice insurance policy
• Notification to staff of completion of credentialing for scheduling and billing
• Maintain and update CAQH online credentialing application for all providers quarterly.
• Database management/provider files
• Maintain vital provider credentialing information via technology tool and hard copies of documents in provider files stored on OneOncology platform.
• Tracking and maintaining all clinical licenses for nursing, pharmacy, and lab personnel
• Provider continuing education
• Track continuing education credits for all providers
• Notify providers of any deficiencies
• Submit documentation if providers are audited
• Termination of physician and/or allied health professional
• Contact all MCO/hospitals/EMR to remove provider who has left practice, within 30 days of termination.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED