Credentialing Specialist

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.

Why join us? 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.

Job Description:

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.

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.

Key Competencies

Proficient with MS Office Suite (word, excel) and web-based applications

Ability to maintain verbal and written communications in a confidential manner

Detail oriented with strong organizational skills

Excellent interpersonal skills – team player who can prioritize multiple responsibilities, manage a large workload within tight deadlines – works well under pressure and consistently meets deadlines, readily adapts to change, and excels in a productivity-based environment

Excellent verbal and written communication skills

Demonstrates research and problem-solving skills

Qualifications

High school diploma and 2+ years of related experience.

Bachelor’s degree preferred.

Training experience preferred but not required

Industry experience leading credentialing activities in large provider practice (or multiple practices) is required

Certifications preferred but not required

Working remote with Travel flexibility as needed.

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