Senior Credential Care Coordinator

US Oncology Network•Teaneck, NJ

9d•Hybrid

About The Position

Overview Regional Cancer Care Associates (RCCA) is seeking an experienced Credentialing Specialist to join our growing team. In this role, you'll be a key player in ensuring our providers are credentialed and ready to deliver exceptional care to patients who need it most. Employment Type: Full Time Location: Teaneck, NJ (Hybrid) Compensation: $50,672 - $68,393 annually Compensation packages based on your unique skills, experience, and qualifications As of the date of this posting, RCCA offers a comprehensive benefits package for this position, subject to eligibility requirements. In addition to the salary, we provide: Health, dental, and vision plans, Wellness program, Health savings account - Flexible spending accounts, 401(k) retirement plan, Life insurance, Short-term disability insurance, Long-term disability insurance, Employee Assistance Program (EAP), Paid Time Off (PTO) and holiday pay, Tuition discounts with numerous universities. We believe these benefits underscore our commitment to the well-being and professional growth of our employees. Responsibilities Payer portal maintenance CAQH maintenance Credentials and re-credentials providers according to quality standards and company policies and procedures. Notifies providers of licensure expirations and submits licensure applications and renewal forms with payment to State agencies and appropriate departments. Recommend process improvements. Maintains current provider licensure files and provides information to hospitals and other healthcare providers as appropriate. Requests and completes hospital credentialing and privileges applications for providers. Obtains and maintains provider participation in managed care plans in a timely manner and communicates information to practice sites and business office. May implement and maintain the contract management system to include terms of the contract, providers credentialed to the payer and other contracted service providers (labs, hospitals). Supports Network Contracting Representative/Manager in general administrative functions. Trains junior and practice staff with respect to credentialing contracts, policies and procedures. Other duties as requested or assigned.

Requirements

High School diploma or equivalent required.
At least five (5) years of credentialing related work experience required.
Proficiency with computer systems and MicroSoft (Office Outlook, Word, Power Point, and Excel) required.

Nice To Haves

Technical certification or Associates Degree a plus.

Responsibilities

Payer portal maintenance
CAQH maintenance
Credentials and re-credentials providers according to quality standards and company policies and procedures.
Notifies providers of licensure expirations and submits licensure applications and renewal forms with payment to State agencies and appropriate departments.
Recommend process improvements.
Maintains current provider licensure files and provides information to hospitals and other healthcare providers as appropriate.
Requests and completes hospital credentialing and privileges applications for providers.
Obtains and maintains provider participation in managed care plans in a timely manner and communicates information to practice sites and business office.
May implement and maintain the contract management system to include terms of the contract, providers credentialed to the payer and other contracted service providers (labs, hospitals).
Supports Network Contracting Representative/Manager in general administrative functions.
Trains junior and practice staff with respect to credentialing contracts, policies and procedures.
Other duties as requested or assigned.