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Credentialing Specialist

Company: Austin Cancer Center
Location: Austin
Posted on: November 19, 2021

Job Description:

The Credentialing Specialist is responsible for all aspects of the privileging and credentialing process for the medical staff at Austin Cancer Centers. This position is responsible for processing applications, verifying information, researching application details, and ensuring processes are in accordance with medical staff bylaws.

Main Job Functions
Assists with the on-boarding process of medical staff candidates. Processes all initial applications for medical staff appointments and clinical privileges.
Processes all medical staff reappointments and renewals prior to expiration date.
Examines, researches, enters data, files, and gathers all information necessary to process information received from providers to support the credentialing process.
Maintains up-to-date physician database, including but not limited to medical license(s), certifications, registrations, permits, educational degrees, Travis County Medical Society memberships, professional liability insurance, and renewal period expiration dates. Communicates upcoming renewal/expiration dates with medical staff.
Maintains organized credential files and assists with inspections by regulatory authorities or accreditation surveyors.
Verifies medical staff licenses for initial appointment, reappointment, license renewal, and temporary privileges.
Maintains data base of current CME's.
Communicates medical staff information to appropriate departments.
Verifies, researches, and responds to telephone and written inquiries from providers and other departments pertaining to provider participation and credentialing status.
Maintains all additions, terminations, and changes to all plans as appropriate.
Implements the physician enrollment and credentialing process for clients who request provider enrollment services. Maintain the timelines on enrollment/credentialing schedules, communicate with providers and other departments to update as needed, clarify carrier information requirements, and maintain a strict level of confidentiality for all matters pertaining to provider credentials.
Reviews new client packet information to determine any enrollment issues.
Coordinates credentialing data needed for enrollment, contracting, and other related purposes. Credentialing data includes but is not limited to the medical degree, Drug Enforcement Administration (DEA) number, state license number, Board certifications, CV, malpractice insurance and state insurance form.
Supervisory Responsibilities
Minimum Qualifications
Ability to project a professional image.
Knowledge of regulatory standards and compliance requirements in addition to departmental policies and procedures.
Knowledge of provider credentialing criteria and processes and general licensing regulations.
Working knowledge and ability to apply professional standards of practice in job situations.
Strong organizational and analytical skills.
Ability to work independently and multi-task.
Working knowledge of personal computer and software applications used in job functions (Order entry, data input etc.)
Education and/or Experience
High school diploma or equivalent required.
Minimum three (3) years of medical staff credentialing experience required, preferable in an oncology setting.
Certificates, Licenses, Registrations

What We Offer
Competitive Salary
401(k) + Employer Match
Medical, Dental, and Vision Insurance
Short and Long Term Disability, Life Insurance
Paid Time Off + Paid Holidays
Employee Assistance Program

Keywords: Austin Cancer Center, Austin , Credentialing Specialist, Other , Austin, Texas

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