physician credentialing specialist

OneOncology

<div>OneOncology is positioning community oncologists to drive the future of medical care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer and other diseases. Our team is bringing together leaders to the market place to help drive OneOncology&rsquo;s mission and vision.
Why join us? This is an exciting time to join OneOncology. Our values-driven culture reflects our startup enthusiasm supported by industry leaders in oncology, urology, technology, and finance. We are looking for talented and highly-motivated individuals who demonstrate a natural desire to improve and build new processes that support the meaningful work of independent physicians and the patients they serve.
Job Description:
The Credentialing Specialist will report to OneOncology&rsquo;s Credentialing Manager. The credentialing specialist is responsible for all aspects of the privileging and credentialing process for physicians and allied health professionals. The Specialist will process applications, verify information, research application details, and assure processes are in accordance with medial staff procedures. The specialists will provide consistent, accurate, and timely credentialing support, enhancing the organizations ability to provide professional services. Work includes the accurate, timely and documented verification of the information provided by the application and maintenance of the highly confidential credentialing related files.
Responsibilities<ul><li>
Credentialing and re-credentialing of physicians and allied health professionals</li><li>
Completion, submission and tracking of credentialing applications with all managed care organizations and hospitals.
</li><li>Apply and validate hospital privileges</li><li>
Obtain malpractice insurance policy</li><li>
Notification to staff of completion of credentialing for scheduling and billing</li><li>
Maintain and update CAQH online credentialing application for all providers quarterly.
</li><li>Database management/provider files</li><li>
Maintain vital provider credentialing information via technology tool and hard copies of documents in provider files stored on OneOncology platform.
</li><li>Tracking and maintaining all clinical licenses for nursing, pharmacy, and lab personnel</li><li>
Provider continuing education</li><li>
Track continuing education credits for all providers</li><li>
Notify providers of any deficiencies</li><li>
Submit documentation if providers are audited</li><li>
Termination of physician and/or allied health professional</li><li>
Contact all MCO/hospitals/EMR to remove provider who has left practice, within 30 days of termination.
</li></ul>Key Competencies<ul><li>
Proficient with MS Office Suite (word, excel) and web-based applications</li><li>
Ability to maintain verbal and written communications in a confidential manner</li><li>
Detail oriented with strong organizational skills</li><li>
Excellent interpersonal skills &ndash; team player who can prioritize multiple responsibilities, manage a large workload within tight deadlines &ndash; works well under pressure and consistently meets deadlines, readily adapts to change, and excels in a productivity-based environment</li><li>
Excellent verbal and written communication skills</li><li>
Demonstrates research and problem-solving skills</li></ul>
Qualifications<ul><li>
High school diploma and 2+ years of related experience.
</li><li>Bachelor&rsquo;s degree preferred.
</li><li>Training experience preferred but not required</li><li>
Industry experience leading credentialing activities in large provider practice (or multiple practices) is required</li><li>
Certifications preferred but not required</li><li>
Working remote with Travel flexibility as needed.</li></ul><h3 class="jobSectionHeader">
#LI-REMOTE</h3></div>

Credentialing Specialist

Marketing Tech Sol

We are looking for a Medical Billing Credentialing Specialist with 1&ndash;2 years of experience in Provider Credentialing and Facility Enrollment within the US healthcare industry. The ideal candidate should have hands-on experience managing payer enrollments, maintaining provider credentials, and working with insurance companies to ensure timely approvals for providers and healthcare facilities.Job Type: Full-Time (On-site) Location: 307F Johar Town, Lahore Shift: Night (6:30 PM &ndash; 3:30 AM)Key Responsibilities<ul><li>Perform provider credentialing and re-credentialing with commercial and government insurance payers.</li><li>Complete and manage facility enrollment for Ambulatory Surgery Centers (ASCs), physician practices, and clinics.</li><li>Prepare, submit, track, and follow up on provider and facility enrollment applications until approval.</li><li>Maintain and update CAQH profiles and provider documentation.</li><li>Coordinate with insurance companies regarding enrollment and credentialing status.</li><li>Process provider additions, terminations, demographic updates, and revalidations.</li><li>Ensure provider licenses, certifications, malpractice insurance, and other required documents remain current.</li><li>Maintain accurate credentialing records, databases, and reports.</li><li>Resolve credentialing and enrollment issues through timely follow-up with payers.</li><li>Stay up to date with payer guidelines and credentialing requirements.</li></ul>Requirements<ul><li>1&ndash;2 years of experience in Medical Billing Credentialing, Provider Credentialing, and Facility Enrollment within the US healthcare industry.</li><li>Hands-on experience with provider credentialing, re-credentialing, and payer enrollment processes.</li><li>Strong knowledge of CAQH, NPI, PECOS, and commercial/government payer enrollment procedures.</li><li>Experience working with Medicare, Medicaid, and commercial insurance payers.</li><li>Excellent communication, organizational, and follow-up skills.</li><li>Proficiency in Microsoft Office (Excel, Word, and Outlook).</li><li>Ability to manage multiple tasks and meet deadlines efficiently.</li></ul>Preferred Qualifications<ul><li>Experience with Ambulatory Surgery Center (ASC) credentialing.</li><li>Familiarity with NextGen or other Practice Management/EHR systems.</li></ul>Salary: Competitive salary based on experience.Work Location: In personApply Now: Please send your resume to itmanagement@mypremierpain.com or WhatsApp +92 325 6872375.Pay: Rs80,000.00 - Rs110,000.00 per monthWork Location: In person

Medical Billing Credentialing Specialist (Facility Enrollment & Provider Credentialing)

Elevate Patient Financial Solutions

<div><div><div>Elevate Patient Financial Solutions has an exciting career opportunity available as an Onboarding Specialist. This position will be a remote based role. The Full Time schedule for this role will be Monday through Friday 8 AM to 5 PM. The temporary role is expected to last 3 to 6 months. There may be a potential for the role to transition to permanent at the end of the assignment.</div>
</div><div>Job Summary</div>
<div></div><div>The Credentialing Specialist serves as the subject matter expert for pre-employment credentialing and compliance processes, providing front-line support to recruiters, hiring managers, candidates, and client partners. This role partners closely with Recruiting, HR, and client stakeholders to ensure all employees meet company and client-specific credentialing, background screening, and occupational health requirements prior to start. 
 
The primary function of this role is to oversee and ensure the timely and accurate completion of all credentialing activities, maintaining compliance with company policies, client requirements, and regulatory standards. Success in this position requires exceptional organization, attention to detail, and strong communication throughout each stage of the credentialing process.</div>
<div></div><div>Essential Duties and Responsibilities</div>
<div></div><ul><li>Coordinate and manage all pre-employment credentialing activities, including background checks, drug screens, occupational health requirements, and client-specific compliance items.</li><li>Ensure timely completion of all credentialing requirements to meet established start date expectations.</li><li>Review, track, and validate completion of all required screening components, including secondary checks, health screenings, and compliance documentation.</li><li>Files onboarding and employment documents into Document Management System from sources including ATS, Background check provider, and client document submissions.</li><li>Conduct detailed reviews of candidate documentation to detect inconsistencies, falsification, or potential fraud, ensuring all findings are documented and escalated in accordance with company and client compliance standards.</li><li>Serve as the primary point of contact for recruiters, hiring managers, candidates, and internal teams regarding credentialing status and updates.</li><li>Communicate proactively on delays, issues, or required escalations impacting candidate start dates or compliance timelines.</li><li>Partner with internal teams and external vendors to resolve credentialing discrepancies and ensure process efficiency.</li><li>Monitor credentialing workflows to ensure consistency, accuracy, and adherence to service level expectations.</li><li>Support compliance with federal, state, and client-specific requirements related to background screening and occupational health standards.</li><li>Builds and fosters relationships with Recruiters, Hiring Managers, employees, applicants, and client contacts to ensure a positive onboarding experience.</li><li>Provide administrative and operational support to the Talent Acquisition and Credentialing teams.</li><li>Assist with reporting, and special projects related to credentialing and onboarding compliance.</li><li>Participates in SOX/SOC internal and external audits.</li><li>Other duties as assigned.</li></ul>
<div>Qualifications and Requirements</div>
<div></div><div>To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or abilities required. 
 
<ul><li>High School Diploma or GED required; Associate or Bachelor's degree preferred.</li><li>3+ years of experience in credentialing, onboarding, or pre-employment compliance processes.</li><li>2+ years of experience supporting background screening and occupational health requirements in a high-volume environment.</li><li>Strong knowledge of credentialing processes, compliance requirements, and screening workflows preferred.</li><li>Experience with Applicant Tracking Systems (ATS) and credentialing or vendor screening platforms preferred.</li><li>Proficiency in Microsoft Office (Word, Excel, Outlook).</li><li>Demonstrated ability to maintain confidentiality and professionalism in all interactions.</li><li>Strong problem-solving and critical thinking skills.</li><li>Proven ability to prioritize tasks, manage multiple deadlines, and follow through effectively.</li><li>Excellent communication skills with the ability to interact across all levels of the organization and with external partners.</li><li>Highly detail-oriented with strong organizational and time management skills.</li><li>Proactive team player with a strong work ethic and ability to adapt in a fast-paced, compliance-driven environment.</li><li>Ability to meet designated deadlines is also a critical qualification.</li><li>Must be able to work in solitary work environment, with a self-starter mentality.</li><li>Remote and Hybrid positions require internet connectivity speeds that meet the Company's minimum upload and download requirements.</li></ul></div> 
<div></div>
<div></div><div>The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, location, specialty and training. This pay scale is not a promise of a particular wage.</div>
<div></div><div>The job description does not constitute an employment agreement between the employer and Employee and is subject to change by the employer as the needs of the employer and requirements of the job change. 
 
ElevatePFS is an Equal Opportunity Employer</div>
<div></div><div>#IND123</div></div><div></div>

Temporary Credentialing Specialist

Inova Health System

<div>Inova Neurosurgery is looking for a dedicated PRN Acute Care Nurse Practitioner or Acute Care Physician Assistant (NP/PA) to join the team. this position will be PRN at Inova Fairfax Medical Campus.
Inova Neurosurgery is one of the countries most advanced neurosurgical practices specializing in brain, endovascular, spine, brain and spine cancer, while working together to provide compassionate integrated care.
Inova is consistently ranked a national healthcare leader in safety, quality and patient experience. We are also proud to be consistently recognized as a top employer in both the D.C. metro area and the nation. 
Featured Benefits:
<ul><li>Committed to Team Member Health: offering medical, dental and vision coverage, and a robust team member wellness program.
</li><li>Retirement: Inova matches the first 5% of eligible contributions &ndash; starting on your first day.
</li><li>Tuition and Student Loan Assistance: offering up to $5,250 per year in education assistance and up to $10,000 for student loans.
</li><li>Mental Health Support: offering all Inova team members, their spouses/partners, and their children 25 mental health coaching or therapy sessions, per person, per year, at no cost.
</li><li>Work/Life Balance: offering paid time off, paid parental leave, flexible work schedules. 
</li></ul>Neurosurgery Advanced Practice Provider Job Responsibilities:
<ul><li>APP will be responsible for all aspects of the service to include daily rounds and progress notes.
</li><li>Emergency Room and inpatient consults, admissions, and discharges
</li><li>Ordering and interpreting labs and radiologic studies
</li><li>Fielding phone calls from inpatient nurses.
</li><li>Multidisciplinary care coordination and patient education.
</li><li>You may also perform procedures - within the scope of practice of Inova Health credentialing and privileging - to include EVD and ICP monitor placement.
</li><li>Some opportunity exists for first-assisting in the OR, as service needs permit or require.
</li>The APP will work directly with the neurosurgeons. 
<li>
</li></ul>Additional Requirements:
<ul><li>Work schedule: PRN - 12 hour shifts. Day/Night/Weekends
</li><li>Education: Masters in Advanced Clinical Practice or graduate of a post masters certificate program for nurse practitioners, OR certificate from an education program that is accredited by the Council of Nurse Anesthesia Educational Programs/Schools, American College of Nurse Midwives, American Association of Colleges of Nursing of the National League for Nursing. For physician Assistants, graduate of an accredited Physician Assistant program and certification by National Commission on Certification of Physician Assistants.
</li><li>Experience: No experience required.
</li><li>Certification: Basic Life Support (BLS) upon start
</li><li>Licensure: Licensed Physician Assistant or Nurse Practitioner; If Nurse Practitioner: RN Compact License(depending on State of primary residence) AND a license (or eligibility for) as a nurse practitioner or physician assistant in the Commonwealth of Virginia AND a &quot;Practice Agreement&quot; signed by sponsoring/ supervising physician(s), AND a written &quot;Scope of Practice/Protocol&quot; signed by the supervising physician, AND &quot;Drug Enforcement Administration License&quot; (if prescribing controlled substances)
</li><li>Payer Credentialing: Ability to successfully complete the credentialing process by third-party payors and Ability to enrolled as a CMS Medicare/Medicaid payor
</li><li>Medical Staff Credentialing : Successful completion of credentialing for Medical Staff membership and appropriate clinical privileges sufficient to perform all required services 
</li></ul>Preferred Qualifications:
<ul><li>Minimum of one year of experience in inpatient neurosurgery, spine, or orthopedics.</li></ul></div>

Neurosurgery Advanced Practice Provider (NP/PA)

OhioHealth

<div>We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be healthy. We inspire hope. We learn, grow, and achieve more &ndash; in our careers and in our communities.
Job Description Summary:
The Advanced Practice Provider (APP), Physician Assistant (PA), or Advanced Practice Registered Nurse (APRN) including Clinical Nurse Specialist (CNS) or Nurse Practitioner (NP), work in collaboration with the physician primarily in the hospital-based inpatient setting caring for acute, chronically ill, or injured patients. May perform various levels of invasive procedures.
Responsibilities And Duties:
Works under direction and in consultation/collaboration with physician and may perform services authorized by the supervising/collaborating physician that are part of the physician's normal course of practice and expertise. Promotes quality outcomes and initiatives. Must have a Supervision Agreement (SA) or Standard Care Arrangement (SCA) with a physician in like practice. Practices within applicable state laws, appropriate boards, and in accordance with his/her/their SA/SCA and delineation of privileges. 
 
 
 
As a High Reliability Organization (HRO), responsibilities require focus on safety, quality and efficiency in performing job duties.
 
 
The job profile provides an overview of responsibilities and duties and is not intended to be an exhaustive list and is subject to change at any time
Minimum Qualifications:
AANP - American Association of Nurse Practitioners - American Association of Nurse Practitioners Certification Board, APRN - Advanced Practice Registered Nurse License - State of Ohio Board of Nursing, NCCPA - National Commission on Certification of Physician Assistants - American Association of Physician Assistants, PA - Physician Assistant - National Commission on the Certification of Physician Assistants
Additional Job Description:
MINIMUM QUALIFICATIONS
Must have a current Physician Assistant License to practice in Ohio and maintain this from the State Medical Board of Ohio. Must have and maintain a current Certification from the national certifying body National Commission on Certification of Physician Assistants (NCCPA).
OR
Must have a current APRN license to practice from the Ohio Board of Nursing and maintain this licensure from the State Nursing Board of Ohio. Must have and maintain current Certification from a national certifying body American Nurses Credentialing Center (ANCC), American Association of Nurse Practitioners (AANP), or American Association of Critical-Care Nurses (AACN).
Work Shift:
Day
Scheduled Weekly Hours :
40
Department
HVP Riverside
Join us!
 
... if your passion is to work in a caring environment
 
... if you believe that learning is a life-long process
 
... if you strive for excellence and want to be among the best in the healthcare industry
Equal Employment Opportunity
OhioHealth is an equal opportunity employer and fully supports and maintains compliance with all state, federal, and local regulations. OhioHealth does not discriminate against associates or applicants because of race, color, genetic information, religion, sex, sexual orientation, gender identity or expression, age, ancestry, national origin, veteran status, military status, pregnancy, disability, marital status, familial status, or other characteristics protected by law. Equal employment is extended to all person in all aspects of the associate-employer relationship including recruitment, hiring, training, promotion, transfer, compensation, discipline, reduction in staff, termination, assignment of benefits, and any other term or condition of employment</div>

Interventional Cardiology Nurse Practitioner

<div>The Neurosurgery APP Inpatient Lead provides clinical leadership and oversight for Advanced Practice Providers within the inpatient neurosurgery service. This role combines expert clinical practice, operational leadership, quality improvement initiatives, staff development, and interdisciplinary collaboration to ensure the delivery of high-quality, patient-centered care. The APP Lead serves as a clinical resource, mentor, and liaison between APPs, physicians, nursing staff, and hospital leadership while maintaining an active clinical practice.
Inova Neurosurgery is one of the countries most advanced neurosurgical practices specializing in brain, endovascular, spine, brain and spine cancer, while working together to provide compassionate integrated care.
Inova is consistently recognized nationally for excellence in safety, quality, patient experience, and workforce culture and is proud to be recognized as a leading healthcare employer both regionally and nationally.
Inova is consistently ranked a national healthcare leader in safety, quality and patient experience. We are also proud to be consistently recognized as a top employer in both the D.C. metro area and the nation. 
Featured Benefits:
<ul><li>Committed to Team Member Health: offering medical, dental and vision coverage, and a robust team member wellness program.
</li><li>Retirement: Inova matches the first 5% of eligible contributions &ndash; starting on your first day.
</li><li>Tuition and Student Loan Assistance: offering up to $5,250 per year in education assistance and up to $10,000 for student loans.
</li><li>Mental Health Support: offering all Inova team members, their spouses/partners, and their children 25 mental health coaching or therapy sessions, per person, per year, at no cost.
</li><li>Work/Life Balance: offering paid time off, paid parental leave, flexible work schedules . 
</li></ul>Neurosurgery Advanced Practice Provider Lead (NP/PA) Job Responsibilities: 
 
<div><ul><li>Delivering expert inpatient care for neurosurgical patients, including assessment, treatment planning, care coordination, and discharge management.
</li><li>Leading daily APP operations, ensuring appropriate staffing, workflow efficiency, and continuity of patient care.
</li><li>Serving as a mentor, educator, and clinical resource for APPs, nursing staff, and interdisciplinary team members.
</li><li>Supporting recruitment, onboarding, training, competency development, and performance management of APP staff.
</li><li>Collaborating with neurosurgeons, nursing leadership, and hospital administration to optimize patient outcomes and operational performance.
</li><li>Leading quality improvement, patient safety, and evidence-based practice initiatives within the neurosurgery service.
</li><li>Developing and implementing clinical protocols, care pathways, and best practices.
</li><li>Monitoring key clinical and operational metrics and identifying opportunities for program improvement.
</li><li>Participating in departmental committees, strategic planning, and service line development initiatives.
</li>Promoting a collaborative, patient-centered culture that supports high-quality care, professional development, and team engagement. 
<li>
</li></ul></div> 
 
 
Neurosurgery Advanced Practice Provider Lead (NP/PA) Minimum Requirements:
<ul><li>Work schedule: Full-time 3/12-hr shifts per week. Some flexibility required depending on service needs. This role is designated as 0.1 administrative and 0.9 clinical.
</li><li>Location: All System hospitals
</li><li>Education: Masters in Advanced Clinical Practice or graduate of a post masters certificate program for nurse practitioners, OR certificate from an education program that is accredited by the Council of Nurse Anesthesia Educational Programs/Schools, American College of Nurse Midwives, American Association of Colleges of Nursing of the National League for Nursing. For physician Assistants, graduate of an accredited Physician Assistant program and certification by National Commission on Certification of Physician Assistants.
</li><li>Experience: No experience required.
</li><li>Certification: Basic Life Support (BLS) upon start
</li><li>Licensure: Licensed Physician Assistant or Nurse Practitioner; If Nurse Practitioner: RN Compact License(depending on State of primary residence) AND a license (or eligibility for) as a nurse practitioner or physician assistant in the Commonwealth of Virginia AND a &quot;Practice Agreement&quot; signed by sponsoring/ supervising physician(s), AND a written &quot;Scope of Practice/Protocol&quot; signed by the supervising physician, AND &quot;Drug Enforcement Administration License&quot; (if prescribing controlled substances)
</li><li>Payer Credentialing: Ability to successfully complete the credentialing process by third-party payors and Ability to enrolled as a CMS Medicare/Medicaid payor
</li><li>Medical Staff Credentialing : Successful completion of credentialing for Medical Staff membership and appropriate clinical privileges sufficient to perform all required services 
</li></ul>Preferred Qualifications:
<ul><li>Minimum of 5 years of experience in Neurosurgery</li></ul></div>

Inpatient Neurosurgery Advanced Practice Provider (NP/PA) Lead

Cancer Specialists of North Florida

<div>Cancer Specialists of North Florida is recruiting for an experienced Advanced Practice Provider &ndash; Regional Float for our busy Specialty Practice. The Advanced Practice Provider (APP) delivers high-quality clinical care under the supervision of a physician and within the licensure Scope of Practice. This position functions as a regional float role, providing clinical support across all CSNF clinic locations as operational needs arise.
The APP provides direct patient care, patient and family education, psychological support, and survivorship planning from the time of diagnosis throughout the continuum of cancer care. The scope of practice includes performing comprehensive assessments and physical examinations, ordering and interpreting diagnostic and laboratory tests, performing invasive procedures, prescribing medications and treatments, ordering chemotherapy and biotherapy regimens, conducting health screenings, and providing patient and family education.
Essential duties and responsibilities include the following:<ul><li>
Performs comprehensive history and physical examinations including psychological assessments, interprets findings and establishes a problem list and plan of care.</li><li>
Performs clinical and diagnostic procedures including complete skin examination, manual breast examination, bimanual pelvic examination, Pap smear, digital rectal examination, fecal occult blood test, as indicated by complete history, physicals examination, gender, age, lifestyle, and personal behavioral risk factors in accordance with other leading professional organizations cancer screening and follow-up guidelines.</li><li>
Collaborates with other healthcare team members involved in patient treatment to ensure continuity of care.</li><li>
Following documented training, performs diagnostic procedures including bone marrow aspirate and biopsy and paracentesis in collaboration with the physician.</li><li>
Orders and interprets diagnostic and laboratory test.</li><li>
Provides pharmacologic management of the disease process and treatment side effects.</li><li>
Manages the clinical course of patients with acute or chronic complaints and end-of-life or other health concerns.</li><li>
Create and implement survivorship care plans for patients. Educate patients regarding information included in the care plan.</li><li>
Evaluate patient qualifications for and order appropriate genetic testing.</li><li>
Promote prevention and early detection by providing education to patients, family, staff and community.</li><li>
Orders or refers patient for appropriate screening exams.</li><li>
Recognizes and initiates lifesaving procedures for oncologic emergencies and brings emergencies to the immediate attention of a physician.</li><li>
Perform hospital rounds on existing patients when needed.</li><li>
Provide on-call services when office is closed (nights, weekends and holidays) on a rotating schedule as required.</li><li>
Maintains patient confidentiality.</li><li>
Perform tasks assigned to staff nurses as necessary.</li></ul>
Full-time Position, Monday &ndash; Friday
CSNF Clinic Locations in Jacksonville, Fleming Island, Middleburg, Neptune Beach, Palm Coast and St. Augustine, FL
Education, Experience, and Licensure:<ul><li>
License to practice as RN or PA in the state of Florida required.</li><li>
Master&rsquo;s degree in nursing or Physician Assistant program is required.</li><li>
National certification as Nurse Practitioner (American Nurses' Credentialing Center or American Academy of Nurse Practitioners), or Clinical Nurse Specialist who meets criteria for certificate of fitness to prescribe medications.</li><li>
Certification by the National Commission on Certification of Physician Assistants required.</li><li>
Minimum of 2 years&rsquo; experience as an oncology-trained APP.</li><li>
Current Basic Life Support (BLS) certification.</li><li>
AOCN or AOCNP certification preferred for Nurse Practitioners.</li></ul>
Compensation and Benefits:<ul><li>
Salary is commensurate with experience and qualifications</li></ul>
Cancer Specialists of North Florida is an &quot;EEO Employer&rdquo; and &ldquo;Drug Free Workplace&rdquo;</div>

Advanced Practice Provider - Regional Float

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