Credentialing Coordinator

Are you looking for a career and not just a job in the medical field? Virginia Cancer Specialists, affiliated with McKesson Specialty Health and US Oncology, a leader in cancer care, is seeking an experienced Full Time Credentialing Coordinator for our Administrative office in Fairfax, Virginia. GREAT BENEFITS INCLUDE: Medical, Dental, Vision, Paid Holidays, and 401(k).

SCOPE: Under minimal supervision, applies credentialing knowledge to efficiently coordinate provider credentialing licensure and hospital privileges activities. Assists in administrative activities to support state/practice managed care functions, which may include provider plan participation, credentialing and contract files. Supports and adheres to the US Oncology Compliance Program to include the Code of Ethics and Business Standards and Shared Values.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

-Credentials and re-credentials providers according to quality standards and company policies and procedures.

-Notifies providers of licensure expirations and submits licensure applications and renewal forms with payment to State agencies and appropriate departments. Recommends process improvements.

-Maintains current provider licensure files and provides information to hospitals and other healthcare providers as appropriate. Requests and completes hospital credentialing and privileges applications for providers.

-Obtains malpractice insurance for providers as necessary.

-Obtains and maintains provider participation in managed care plans in a timely manner and communicates information to practice sites and business office.

-Notifies government and managed care plans of physician terminations or transfers in a timely manner.

-Assists in providing documentation for Peer Review.

-Supports Network Contracting Representative/Manager in general administrative functions.

-Trains junior and practice staff with respect to credentialing contracts, policies and procedures.

-Other duties as requested or assigned.

MINIMUM QUALIFICATIONS: High School diploma or equivalent required. Technical certification or Associates Degree a plus. At least five (5) years of credentialing related work experience required. Proficiency with computer systems and MicroSoft (Office Outlook, Word, Power Point, and Excel) required.

COMPETENCIES: Uses Technical and Functional Experience: Possesses up to date knowledge of the profession and industry; is regarded as an expert in the technical/functional area; accesses and uses other expert resources when appropriate.

Demonstrates Adaptability: Handles day to day work challenges confidently; is willing and able to adjust to multiple demands, shifting priorities, ambiguity and rapid change; shows resilience in the face of constraints, frustrations, or adversity; demonstrates flexibility.

Uses Sound Judgment: Makes timely, cost effective and sound decisions; makes decisions under conditions of uncertainty.

Shows Work Commitment: Sets high standards of performance; pursues aggressive goals and works efficiently to achieve them.

Commits to Quality: Emphasizes the need to deliver quality products and/or services; defines standards for quality and evaluated products, processes, and service against those standards; manages quality; improves efficiencies.

PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is required to be present at the employee site during regularly scheduled business hours and regularly required to sit or stand and talk or hear. Requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination. Requires standing and walking for extensive periods of time. Occasionally lifts and carries items weighing up to 40 lbs. Requires corrected vision and hearing to normal range. WORK ENVIRONMENT: The work environment may include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations and other conditions common to an oncology/hematology clinic environment. Work will involve in-person interaction with co-workers and management and/or clients. Work may require minimal travel by automobile to office sites.

Join us at Virginia Cancer Specialists, where meeting and exceeding the needs of our patients is our primary goal!

The US Oncology Network is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin.