Credentialing Specialist

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<p style="text-align:left !important">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.</p><p style="text-align:inherit !important"></p><p style="text-align:inherit !important"></p><p style="text-align:left !important">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.</p><p style="text-align:inherit !important"></p><p style="text-align:inherit"></p><p style="text-align:left"><b>Job Description:</b></p><div><div><p><span><span>The </span></span><b><span>Credenti</span><span>aling Specialist</span></b><span><span> will report to </span><span>OneOncology’s</span><span><span> </span></span></span><b><span>Credentialing Supervisor</span></b><span><span>.</span></span><span><span> </span><span>The credentialing specialist<span> </span></span><span>is responsible for</span><span><span> </span>all aspects of the<span> </span></span><span>privileging</span><span><span> </span>and credentialing process for physicians and allied health professionals. The Specialist will process applications, verify information, research application details, and<span> </span></span><span>assure</span><span><span> </span>processes are<span> </span></span><span>in accordance with</span><span><span> </span></span><span>medial</span><span><span> </span>staff procedures. The specialists will provide consistent,<span> </span></span><span>accurate</span><span>, and<span> </span></span><span>timely</span><span><span> </span>credentialing support, enhancing the<span> </span></span><span>organization’s</span><span><span> </span>ability to provide professional services. Work includes the<span> </span></span><span>accurate</span><span>,<span> </span></span><span>timely</span><span><span> </span>and documented verification of the information provided by the application and maintenance of the highly confidential credentialing related files</span><span>. </span></span><b><span> </span></b><span> </span></p></div><div><p><span> </span></p></div><div><p><b><span>Responsibilities</span></b><span> </span></p></div><div><ul><li><p><span><span>Credentialing and re-credentialing of physicians and<span> </span></span><span>advanced practice providers.</span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Completion, submission and tracking of credentialing applications with all managed care organizations and hospitals. </span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Apply<span> </span></span><span>for<span> </span></span><span>and<span> </span></span><span>validate</span><span><span> </span>hospital privileges</span><span>.</span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Obtain malpractice insurance policy</span><span>.</span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Notification to staff<span> </span></span><span>of</span><span><span> </span>completion of credentialing for scheduling and billing</span><span>.</span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Maintain and update CAQH online credentialing<span> </span></span><span>application</span><span><span> </span>for all providers quarterly. Database management/provider files</span><span>.</span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Maintain vital provider credentialing information via technology tool and hard copies of documents in provider files stored on<span> </span></span><span>OneOncology</span><span><span> </span>platform. </span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Tracking and<span> </span></span><span>maintaining</span><span><span> </span>all clinical licenses for nursing, pharmacy, and lab personnel</span><span>.</span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Provider continuing education</span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Track continuing education credits for all providers</span><span>.</span></span><span> </span></p></li></ul></div></div><div><div><ul><li><p><span><span>Notify providers of any deficiencies</span><span>.</span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Submit documentation if providers are audited</span><span>.</span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Termination of physician and/or allied health professional</span><span>.</span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Contact all MCO/hospitals/EMR to remove<span> </span></span><span>provider</span><span><span> </span>who<span> </span></span><span>has</span><span><span> </span>left practice, within<span> </span></span><span>30 days</span><span><span> </span>of termination. </span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Other tasks as assigned to drive our mission of improving the lives of everyone living with cancer. </span></span><span> </span></p></li></ul></div><div><p></p><p><b><span>Key Competencies</span></b><span> </span></p></div><div><ul><li><p><span><span>Experience working with NCQA criteria and<span> </span></span><span>third-party</span><span><span> </span>payer regulations.</span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Experience with</span><span><span> </span>completing hospital credentialing applications.</span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Proficient with MS Office Suite (word, excel) and<span> </span></span><span>web-based</span><span><span> </span>applications</span><span>.</span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Ability to<span> </span></span><span>maintain</span><span><span> </span>verbal and<span> </span></span><span>written communications</span><span><span> </span>in a confiden</span><span>tial manner</span><span>.</span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Detail</span><span><span> </span>oriented with strong organizational skills</span><span>.</span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Excellent interpersonal skills – team<span> </span></span><span>player</span><span><span> </span>who<span> </span></span><span>can</span><span><span> </span>prioritize multiple responsibilities, manage a large workload within tight deadlines – works well under pressure and consistently meets deadlines, readily adapts to<span> </span></span><span>change,</span><span><span> </span>and excels in a<span> </span></span><span>productivity-based</span><span><span> </span>environment</span><span>.</span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Demonstrates research and problem-solving skills</span><span>.</span></span><span> </span></p></li></ul></div><div><p></p><p><b><span>Qualifications</span></b><span> </span></p></div><div><ul><li><p><span><span>Current working knowledge of enrollment processes with California<span> </span></span><span>payors</span><span>, Commercial and Government.</span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>High school diploma and 2+ years of related experience</span><span>. </span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Bachelor’s degree preferred. </span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Industry experience<span> </span></span><span>leading credentialing activities<span> </span></span><span>in<span> </span></span><span>large provider<span> </span></span><span>practice</span><span><span> </span>(or multiple practices</span><span>)<span> </span></span><span>is<span> </span></span><span>required</span><span>.</span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Certifications</span><span><span> </span></span><span>preferred</span><span><span> </span>but not<span> </span></span><span>required</span><span>.</span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Working remote<span> </span></span><span>with<span> </span></span><span>Travel flexibility<span> </span></span><span>as needed. </span></span><span> </span></p></li></ul></div></div><div><div><ul><li><p><span><span>Working Pacific Standard Time hours.</span></span><span> </span></p></li></ul><p></p><h3><span>#LI-REMOTE </span></h3></div></div>

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Common Interview Questions And Answers

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This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...