Remote Credentialing Specialist: Provider Privileges

Astera Cancer Care; Nashville (TN); On-site; USD 45,000 - 65,000; Full time

Job summary

OneOncology is seeking a Credentialing Specialist to manage all aspects of privileging and credentialing for physicians and allied health professionals. The role includes processing applications, verifying information, and ensuring compliance with medical staff procedures.

You will maintain CAQH profiles, track licenses, and coordinate with hospitals and managed care organizations while working remotely with travel as needed.

Qualifications

• High school diploma and 2+ years of related experience.
• Bachelor’s degree preferred.
• Experience in credentialing activities in large provider practice preferred but not required.
• Industry experience leading credentialing activities is a plus.

Responsibilities

• Credentialing and re-credentialing of physicians and allied health professionals.
• Completion, submission and tracking of credentialing applications with managed care organizations and hospitals.
• Apply and validate hospital privileges.
• Obtain malpractice insurance policy.
• Notify staff of credentialing completion for scheduling and billing.
• Maintain CAQH online credentialing application for providers.
• Database management and provider files maintenance.
• Track continuing education credits for all providers.
• Notify providers of deficiencies; submit documentation if audited.
• Terminate providers as appropriate.
• Contact all MCOs/hospitals/EMR to remove providers within 30 days of termination.

Skills

MS Office Suite

Web-based applications

Verbal communication

Written communication

Organizational skills

Team player

Education

High school diploma

Bachelor’s degree preferred

Tools

CAQH

Job description

OneOncology is seeking a Credentialing Specialist to manage all aspects of privileging and credentialing for physicians and allied health professionals. The role includes processing applications, verifying information, and ensuring compliance with medical staff procedures.

You will maintain CAQH profiles, track licenses, and coordinate with hospitals and managed care organizations while working remotely with travel as needed.