"Alerted.org

Duties/Responsibilities:

Will be the primary point of contact for all delegated entities with regards to onboarding/credentialing providers. Responsible for the resolution of all issues, including those identified by the provider, and those identified internally that impact the physician.

Schedules regular meetings with assigned delegated entities to identify and trouble shoot issues. Trains//educates entities regarding the onboarding delegated process.

Responsible for investigations to ensure online Provider directory is updated and accurate. Makes all changes necessary to ensure the directory is at all times accurate.

Configures new Provider loads, updates and terminations. Provides assistance and guidance with large ad-hoc data entry projects in MHS.

Performs quarterly roster reconciliations to ensure that the health plan directory is current, accurate and adheres to department guidelines, regulations, and government laws. Tasked with making required changes to ensure directory is compliant.

Designated to receive and review provider credentialing applications. Coordinates with hospital//clinic, medical staff, and practitioners to ensure privileging process is timely completed. Determines whether additional documentation, verifications, references, and//or applications are needed.

Receives, reviews and submits provider contracts

Coordinates with Network Management staff to finalize provider applications and contracts. Responsible for all follow-up so that timely approval occurs.

Reports to Team Lead

Additional duties as assigned

Minimum Qualifications:

Associate's Degree or above.

Familiarity with Credentialing and Provider rosters

Understanding Network Management

Must have experience working as a liaison with providers and internal support groups

Must have experience meeting deadlines under time sensitive constraints

Must have experience adapting to last minute project requests

Must have experience working independently with minimal supervision

Must have ability to communicate effectively with providers and internal staff members

Demonstrated willingness to be flexible and adaptable to changing priorities

Time management skills with ability to manage multiple tasks

Computer proficient (i.e. excel, V lookup, pivot, formulas, reporting)

Oral and written communication skills

Critical thinking skills

Preferred Qualifications:

Bachelors Degree or above

Experience with MHS, DocuSign and CRM software

Compliance & Regulatory Responsibilities: N/A

License//Certification: N/A

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.