Credentialing Specialist

OneOncology; Nashville (TN); Remote; USD 45,000 - 65,000; Full time

Benefits offered by this job

Remote work with travel flexibility

Job summary

OneOncology, LLC is seeking a Credentialing Specialist to manage privileging and credentialing for physicians and allied health professionals. The role encompasses application processing, information verification, and maintaining confidential credentialing files within the OneOncology platform.

You will handle CAQH updates, provider licenses, and communication with MCOs and hospitals, ensuring timely credentialing and accurate scheduling support across a remote, travel-flexible setting.

Qualifications

• High school diploma required; 2+ years of related experience.
• Bachelor’s degree preferred.
• Experience in credentialing or medical staff processes is a plus.
• Strong organizational skills and attention to detail.

Responsibilities

• Process credentialing and re-credentialing for physicians and allied health professionals.
• Submit applications with managed care organizations and hospitals.
• Apply and validate hospital privileges and malpractice insurance.
• Maintain CAQH online credentialing for all providers quarterly.
• Track licenses for nursing, pharmacy, and lab personnel.
• Notify staff of credentialing completion for scheduling and billing.
• Maintain provider credentialing files on OneOncology platform.

Skills

MS Office Suite

Verbal and written communication

Detail oriented

Education

High school diploma

Bachelor's degree preferred

Tools

Web-based applications

Job description

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.ResponsibilitiesCredentialing and re-credentialing of physicians and allied health professionalsCompletion, submission and tracking of credentialing applications with all managed care organizations and hospitals.Apply and validate hospital privilegesObtain malpractice insurance policyNotification to staff of completion of credentialing for scheduling and billingMaintain and update CAQH online credentialing application for all providers quarterly.Database management/provider filesMaintain 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 personnelProvider continuing educationTrack continuing education credits for all providersNotify providers of any deficienciesSubmit documentation if providers are auditedTermination of physician and/or allied health professionalContact all MCO/hospitals/EMR to remove provider who has left practice, within 30 days of termination.Key CompetenciesProficient with MS Office Suite (word, excel) and web-based applicationsAbility to maintain verbal and written communications in a confidential mannerDetail oriented with strong organizational skillsExcellent 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 environmentExcellent verbal and written communication skillsDemonstrates research and problem-solving skillsQualificationsHigh school diploma and 2+ years of related experience.Bachelor’s degree preferred.Training experience preferred but not requiredIndustry experience leading credentialing activities in large provider practice (or multiple practices) is requiredCertifications preferred but not requiredWorking remote with Travel flexibility as needed.#LI-REMOTE