Credentialing Coordinator

Credentialing Coordinator with The Oncology Institute offers a unique opportunity to contribute meaningfully to the healthcare system. By ensuring that healthcare providers possess the necessary qualifications and credentials to deliver specialized care to oncology patients, you directly impact the quality and safety of cancer treatment. Your role facilitates the smooth operation of healthcare facilities, ensuring compliance with regulatory standards and fostering trust between patients, providers, and institutions. You will play a vital role in supporting the ongoing advancement of oncology care by maintaining accurate records and staying abreast of evolving credentialing requirements and best practices. This position allows you to make a tangible difference in the lives of cancer patients by enabling access to high-quality, specialized care.

Job Duties:

1. Functions as part of a team in the provision of credentialing and privileging of practitioners, allied staff and other licensed personnel.
2. Participates with outside agencies that relate to the Credentialing process, such as ICE (Industry Collaboration Effort), CAMMS (California Association Medical Staff Services), and health plans.
3. Participates in credentialing meetings.
4. Maintaining compliance with regulatory and accrediting bodies; Joint Commission, NCQA and HRSA/FTCA credentialing requirements.
5. Responsible for ensuring Medicare, Medi-Cal, Special Programs and CAQH clinic applications, including Pharmacy are completed accurately and submitted in an efficient and timely manner.
6. Knowledgeable and efficient in submitting applications
7. May assist providers and/or department staff in completing credentialing applications and necessary paperwork.
8. Collaborates with inter-departmental peers, including Quality Management, Operations, Human Resources, and Medical to identify and implement best practices and to ensure an integrated, timely and consistent product.
9. Communicates with all TOI staff verbally, email, memo or phone as appropriate.
10. Ability to work cooperatively in a team environment to support and advance the mission, vision and goals of The Oncology Institute
11. Performs other duties as assigned or required.

Additional Duties:

1. HIPAA compliance - Responsible for maintaining abreast of and in compliance with all regulations and requirements as defined under the Health Insurance Portability and Accountability Act (HIPAA). Is expected to treat all TOI team member's information as sensitive and confidential.
2. Compliance - Ensure compliance with all local, state and federal regulations.\
3. QA/QI - Participate in QA/QI activities and contribute towards the overall performance improvement of the organization.

Qualifications, Experience, and Education:

EDUCATION: High School, GED

EXPERIENCE: Two (2) years of credentialing experience in healthcare with a thorough understanding of credentialing and privileging.

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