Credentialing Specialist

Astera Cancer Care; Hillmont (AL); On-site; USD 42,000 - 62,000; Full time

Job summary

Clearview Cancer Institute, a leading north Alabama oncology center, seeks a Credentialing Specialist to manage provider credentialing for hospitals, payers, Medicare and Medicaid. You will ensure CAQH records are current and renew licenses (Professional, DEA, Controlled Substances) as required.

The position supports physicians and physician extenders in a fast-paced hematology/oncology clinic, handling credentialing files and government payer requests with accuracy and speed.

Qualifications

• High School Diploma or GED required; 2 years credentialing experience preferred.
• 2 years medical office experience required.
• Knowledge of provider credentialing processes for hospitals, payers, Medicare and Medicaid.
• Detail oriented with strong organizational skills and deadlines.
• Excellent customer service and clear communication.

Responsibilities

• Maintain provider files with up-to-date credentialing information.
• Update CAQH database files on schedule.
• Apply for and renew provider licenses (Professional, DEA, Controlled Substances).
• Credential new providers and re-credential current providers with hospitals.
• Maintain online document storage and paper files.
• Perform other duties as assigned.

Skills

Credentialing knowledge

Excel

SharePoint

Word

Internet use

Customer service

Attention to detail

Education

High School Diploma or GED

Tools

Excel

SharePoint

Word

Internet

Job description

Clearview Cancer Institute is north Alabama's leading cancer treatment facility. For over 30 years Clearview Cancer Institute has provided leading-edge treatment and compassionate care to those diagnosed with cancer or blood disorders. Clearview offers every service and amenity needed in an outpatient setting and our dedication to research and involvement in Phase I-IV clinical trials gives our patients the opportunity to receive potentially life-saving treatment options.Why Join Us? We are looking for talented and highly-motivated individuals who demonstrate a natural desire to support the meaningful work of community oncologists and the patients we serve.Job Description:Job PurposeThe Credentialing Specialist is responsible for maintaining active status for all providers by successfully completing initial and subsequent credentialing packages as required by hospitals, commercial payers, Medicare, and Medicaid.Essential Job FunctionsMaintain individual provider files to include up to date information needed to complete the requiredgovernmental and commercial payer credentialing applicationsUpdate each provider’s CAQH database file timely according to the schedule published by CMSApply for and renew annually all provider licenses; Professional, DEA, Controlled SubstanceComplete revalidation requests issued by government payersComplete credentialing/re-credentialing applications to add providers to commercial payers, Medicare, and MedicaidCredential new providers and re-credential current providers with hospitals at which they hold staff privilegesMaintaining online document storage; labeling and updating paper filesOther duties as assignedQualificationsKnowledge of provider credentialingExcellent computer skills including Excel, SharePoint, Word, and Internet useDetail oriented with above average organizational skillsPlans and prioritizes to meet deadlinesExcellent customer service skills; communicates clearly and effectivelyEducation/ExperienceHigh School Diploma or GED2 years credentialing experience preferred2 years medical office experience requiredWorking conditionsThis position works in a busy hematology/oncology clinic but has no direct patient contact. This person is responsible for the credentialing of physicians and physician extenders so interaction with both is required.Physical requirementsThis position requires the employee be able to sit at a desk for up to eight hours a day. It also requires standing and walking for up to two-thirds of the day on some days in order to complete tasks.Direct reportsThis is not a supervisory position.