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Highlands Oncology Group PA

Credentialing Specialist

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Job Description

Behind every exceptional healthcare team is a credentialing expert ensuring providers are ready to deliver care. As a Credentialing Specialist, you'll play a vital role in maintainingcompliance, managing provider enrollment, and ensuring clinicians are credentialed accurately and efficiently. Join a team where your attention to detail directly supports quality patient care. Highlands Oncology began in 1996 with three physicians and a desire to change the face of oncology care in our community. Dr. Malcolm Hayward, Dr. Dan Bradford, and Dr. Thad Beck knew that patients do better at home, in the community where they live and work, and where their support system is already in place. In furthering that goal, Highlands has grown with the region from a single location 26 years ago, to 6 locations in Northwest and Northcentral Arkansas today employing more than 800 diverse team members. As Northwest Arkansas continues to grow, so must the services and providers available in the region. Highlands Oncology is committed to remaining on the cutting edge to ensure our community has access to the very best cancer care. What we have is something quite unique right here in our own backyard with a caring multidisciplinary team focused on treating patients like family.
Job Summary:
The Credentialing Specialist, under the general direction of the Credentialing Coordinator, provides administrative, operational, and provider-facing support for Highlands Oncology Group, P.A.'s credentialing, recredentialing, privileging, enrollment, and related provider compliance processes. This position supports the Credentialing Coordinator and Credentialing and Enrollment Analyst(s) by collecting and maintaining required information and documentation, preparing and tracking applications and submissions, monitoring deadlines and outstanding requirements, performing routine verifications, maintaining credentialing systems and records, and following up with providers and other stakeholders. The Credentialing Specialist performs assigned duties in accordance with established procedures and department direction and promptly escalates deficiencies, conflicting requirements, unusual circumstances, adverse determinations, or matters requiring interpretation or independent judgment to the Credentialing Coordinator or Credentialing and Enrollment Analyst. Job Duties /
Responsibilities:
Provides administrative, operational, and provider-facing support to the Credentialing Coordinator and Credentialing and Enrollment Analyst(s) in credentialing, recredentialing, privileging, enrollment, and related provider compliance activities.

Compiles, maintains, updates, and tracks accurate credentialing and demographic information for Highlands providers and facilities in accordance with established procedures.

Assists with the preparation, completion, submission, and tracking of provider credentialing, recredentialing, privileging, enrollment, revalidation, and related applications and supporting doc...