Provider Enrollment Intake Coordinator
Steward Health Care Network
Steward Health Care Network
Position Purpose: Reporting to the Provider Enrollment Supervisor, the Provider Enrollment Intake Coordinator facilitates the daily intake of ongoing enrollment requests of SHCN providers into health plan contracts.
Oversee and triage incoming department Emails. Monitor and assign enrollment requests to Provider Enrollment Liaisons. Notify internal departments and providers of payer enrollment statuses and update provider database accordingly. Submission of system access requests forms for new providers joining the network.
Management of SHCN provider contracts; including coordination of countersignature, uploading into department systems, and mailing fully executed documents to providers. Work closely with SHCN, its affiliates, and the health plans to reconcile any differences in listings of enrolled SHCN physicians. Coordinates these efforts with and through the local chapter offices and SMG Provider Enrollment and works with SHCN Analytic Team to implement changes in provider data.
Conducts ongoing audit of the process to ensure accuracy of provider data. Ensure that SHCN has an accurate and up-to-date listing of all employed and SHCN affiliated physicians at all times and that each of the contracted health plans does as well.
Identifies opportunities for improvements in the process and develops strategies to implement appropriate changes/enhancements; Develop partnerships with relevant staff at the health plans in coordinating enrollment of SHCN providers; independently troubleshooting issues as they arise.
Maintain on-going participation in cross-training activities, ensuring appropriate staff coverage of incoming volume. Actively engage in addressing special projects as they arise, conducting preliminary research and follow-up, and tracking/monitoring to facilitate on-going reporting of project status. Provides valid feedback to the Provider Enrollment Supervisor on departmental issues and progress. Perform other functions as assigned.
* Associates degree in a related field (or equivalent combination of education and experience).
Years of Experience:
* A minimum of one year administrative experience, preferably within a healthcare environment.
Work Related Experience:
* Familiarity with Microsoft Office software (Outlook, Word, Access, Excel, PowerPoint)
* Previous Managed Care and/or Medicaid experience strongly preferred.
* Ability to analyze and evaluate data and other provider related problems in order to develop alternative solutions for a positive outcome.
* Ability to multi-task and prioritize workload, manage multiple priorities, and pay meticulous attention to detail.
* Thorough understanding of managed care principles and physician practice operations, with an understanding of health plan provider enrollment and credentialing preferred.
* Excellent organizational skills, proven project management expertise; Strong verbal and written communication skills.
* Outstanding interpersonal skills, able to quickly establish a trusting rapport with individuals at all levels.
* Requisite poise, judgment, and trustworthiness to represent SHCN to internal and external groups.
* Maintains information in a confidential manner according to policy.
Job Reference #: 53661