- Functions as part of a team in the provision of credentialing and privileging of practitioners, allied staff and other licensed personnel.
- 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.
- Participates in credentialing meetings.
- Maintaining compliance with regulatory and accrediting bodies; Joint Commission, NCQA and HRSA/FTCA credentialing requirements.
- 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.
- Knowledgeable and efficient in submitting applications
- May assist providers and/or department staff in completing credentialing applications and necessary paperwork.
- 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.
- Communicates with all TOI staff verbally, email, memo or phone as appropriate.
- Ability to work cooperatively in a team environment to support and advance the mission, vision and goals of The Oncology Institute
- Performs other duties as assigned or required.
- 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.
- Compliance - Ensure compliance with all local, state and federal regulations.\
- QA/QI - Participate in QA/QI activities and contribute towards the overall performance improvement of the organization.
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Credentialing Coordinator - Cerritos, United States - The Oncology Institute of Hope and Innovation
Description
Job Description
Job DescriptionFounded in 2007, The Oncology Institute of Hope and Innovation (TOI) is advancing oncology by delivering highly specialized, value-based cancer care in the community setting. TOI is dedicated to offering cutting edge, evidence-based cancer care to a population of more than 1.7 million patients including clinical trials, stem cell transplants, transfusions, and other care delivery models traditionally associated with the most advanced care delivery organizations. With 100+ employed clinicians and more than 800 teammates in 60+ clinic locations and growing. TOI is changing oncology for the better.
Job Duties:
Additional Duties:
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.
The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role.
Pay Transparency for hourly teammates$19—$21 USD