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 is responsible for all aspects of the privileging and credentialing process for physicians and Allied Health Professionals. The Specialist will processes applications, verify information, research application details, and assure processes are in accordance with medical staff procedures. The Specialists will provide consistent, accurate, and timely credentialing support, enhancing the organization’s ability to provide professional services. Work includes the accurate, timely and documented verification of the information provided by the applicant and maintenance of the highly confidential credentialing related files.

ESSENTIAL FUNCTIONS:

Credentialing and Re-credentialing of Physicians and Allied Health Professionals

Completion, submission and tracking of credentialing applications with all Managed Care Organizations (MCO’s) 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 Council for Affordable Quality Healthcare (CAQH) online credentialing application for all providers quarterly.

Database Management/Provider Files

Maintain provider credentialing vital information in Intellisoft database (electronic) and hard copies of documents in provider files

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/SVMIC to remove provider who has left practice, within 30 days of termination.

KNOWLEDGE, SKILLS & ABILITIES:

· 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 is able to 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

· Strong commitment to customer service and a focus on internal and external customer satisfaction

· Demonstrates research and problem solving skills

EDUCATION & EXPERIENCE:

High School Diploma or General Education Degree (GED) and 2+ years of related experience; or equivalent combination of education and experience