Credentialing Specialist

Credentialing Specialist

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 Purpose

The 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 Functions

• Maintain individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applications
• Update each provider's CAQH database file timely according to the schedule published by CMS
• Apply for and renew annually all provider licenses; Professional, DEA, Controlled Substance
• Complete revalidation requests issued by government payers
• Complete credentialing/re-credentialing applications to add providers to commercial payers, Medicare, and Medicaid
• Credential new providers and re-credential current providers with hospitals at which they hold staff privileges
• Maintaining online document storage; labeling and updating paper files
• Other duties as assigned

Qualifications

• Knowledge of provider credentialing
• Excellent computer skills including Excel, SharePoint, Word, and Internet use
• Detail oriented with above average organizational skills
• Plans and prioritizes to meet deadlines
• Excellent customer service skills; communicates clearly and effectively

Education/Experience

• High School Diploma or GED
• 2 years credentialing experience preferred
• 2 years medical office experience required

Working conditions

This 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 requirements

This 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 reports

This is not a supervisory position.