Enrollment Specialist

Oneoncology - Nashville, TN

Full-time - Entry Level

Onsite - Nashville, TN

Hospitals

About the position

The Enrollment Specialist at OneOncology plays a crucial role in managing the credentialing and privileging process for physicians and allied health professionals. This position is essential for ensuring that all credentialing activities are conducted accurately and in compliance with medical staff procedures, thereby supporting the organization's mission to improve cancer care through a patient-centric approach.

Responsibilities

• Credentialing and re-credentialing of physicians and advanced practice providers.
• Completion, submission, and tracking of credentialing applications with all managed care organizations and hospitals.
• Apply for and validate hospital privileges.
• Obtain malpractice insurance policy.
• Notify staff of completion of credentialing for scheduling and billing.
• Maintain and update CAQH online credentialing application for all providers quarterly.
• Database management/provider files.
• Maintain 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 personnel.
• Track continuing education credits for all providers and notify providers of any deficiencies.
• Submit documentation if providers are audited.
• Contact all MCO/hospitals/EMR to remove provider who has left practice, within 30 days of termination.
• Other tasks as assigned to drive our mission of improving the lives of everyone living with cancer.

Requirements

• Current working knowledge of enrollment processes with California payors, Commercial and Government.
• High school diploma and 2+ years of related experience.
• Bachelor's degree preferred.
• Industry experience leading credentialing activities in large provider practice (or multiple practices) is required.
• Experience working with NCQA criteria and third-party payer regulations.
• Experience with completing hospital credentialing applications.

Nice-to-haves

• Certifications preferred but not required.

Benefits

• Remote work flexibility
• Opportunity to work with industry leaders in oncology, technology, and finance.