Operations Coordinator

Job Description

Job Description

Description : ABOUT US

ABOUT US

We value diversity and inclusivity as strengths that make our teams successful, and we are passionate about helping our employees reach their full potential.

As an Operations Coordinator for Patient Care Health, we want you to feel that your employment with us will be meaningful, mutually beneficial, and enjoyable.

POSITION SUMMARY

We are seeking an experienced Operations Coordinator that will be an instrumental for the growth of our provider-facing organization.

The role will act as primary liaison between providers interested in Patient Care Health MSO Services. This includes credentialing, enrolling and contracting through PCH MSO .

Key responsibilities will include :

• Obtaining contracting objectives
• Issue resolution
• Onboarding new providers and practices
• Contracting with all applicable ACA and Medicare plans
• Roster management for assigned payers and practices
• CRM record management
• Payer and practice relations
• Special project implementation
• Promoting provider satisfaction

Requirements :

ROLE RESPONSIBILITIES

• Acts as a primary liaison to health care providers to initiate communication (face of the MSO) and is responsible for communicating needs of providers back to MSO and to support the provider network
• Develops, implements and maintains provider communications (manuals, reference materials, , reports, etc)
• Inter-departmental resource for all provider / contract network issues, problems or concerns
• Monitor and participate in the development of special projects as assigned
• Ensure Provider issues are triaged to appropriate internal department
• Optimizes and maintains payer enrollment processes to ensure accurate, timely data is provided to payers, per network contract requirements.
• Facilitates and confirms resolution of network provider issues related to payers, and other partners, including but not limited to contracting, network status, billing and claims, and attribution in a timely fashion.
• Keeps apprised of updates related to the credentialing process, payer requirements, and hospital privilege requirements and assists team with these functions when needed to meet deadlines.
• Represents department in internal and external meetings, providing status updates on credentialing, provider enrollment or implementations.
• Manages and maintains onboarding documents and member records so CRM is the accurate source of truth for network participation.

Works with development team on enhancements to the system, as needed.

• Oversees network roster submissions to internal and external stakeholders.
• Performs ad hoc and root-cause analysis as directed.
• Maintains network service inbox for enrollment correspondence.
• Works collaboratively in a team-oriented environment with a strong customer-service orientation.

MINIMUM REQUIRED QUALIFICATIONS :

• 2 year certificate or degree from College or Technical School; or related experience, training or combination of education and experience
• Spanish language fluency written and verbal
• Ability to deal with problems and different situations
• Ability to manage credentialing systems, payer rosters, and enrollment information using analytics and data integrity.
• Proficiency in Microsoft Office applications.
• Ability to manage multiple initiatives and prioritize based on time constraints.
• Consistently think through and execute innovative approaches to solving business problems.
• Strong attention to detail and accuracy.
• Value people; demonstrate professional respect and innovative mindset.
• Ability to motivate others to perform at the highest level and passionate about team member development.
• Team focus - working in a collaborative environment.
• Confident in working with health care professionals, insurance payers, and strategic partners
• Passionate about your work and moving forward with purpose.
• Ability to present issues to providers / clients with proposed solutions.

PREFERRED EXPERIENCE :

• Bachelor’s Degree
• Medical Terminology knowledge
• Insurance carrier or RCM experience
• Knowledge of NPPES, CAQH, HCQA, and delegation requirements
• CRM Experience
• Comprehensive knowledge and 4-6+ years' experience in credentialing, delegated credentialing, and payer enrollment.

WHAT WE OFFER

• Above Industry Average Salary (with Bonus Programs)
• Unlimited Paid Time Off
• Comprehensive Employee Benefits Package (Health, Dental, Vision Insurance + 401k)
• Growth Opportunities

NOTE

This job description in no way states or implies that these are the only duties to be performed by the employee(s) incumbent in this position.

Employees will be required to follow any other job-related instructions and to perform any other job-related duties requested by any person authorized to give instructions or assignments.

All duties and responsibilities are essential functions and requirements and are subject to possible modification to reasonably accommodate individuals with disabilities.

To perform this job successfully, the incumbents will possess the skills, aptitudes, and abilities to perform each duty proficiently.

Some requirements may exclude individuals who pose a direct threat or significant risk to the health or safety of themselves or others.

The requirements listed in this document are the minimum levels of knowledge, skills, or abilities. This document does not create an employment contract, implied or otherwise, other than an at will relationship.

Agile People and Payroll provides equal employment opportunities to all applicants, without regard to unlawful considerations of or discrimination against race, religion, creed, color, nationality, sex, sexual orientation, gender identity, age, ancestry, physical or mental disability, medical condition or characteristics, marital status, or any other classification prohibited by applicable local, state, or federal laws.

Agile People and Payroll may obtain a 'consumer report' about you from a consumer reporting agency for employment purposes.

A 'consumer report’ is a background screening report that may contain information regarding your criminal history, driving history, and information about you.

Job Type : Full-time

Schedule : Monday - Friday

Compensation package :

Base Pay : $60,000.00 - $85,000.00 per year

Benefits : 401(k)

401(k)

Dental insurance

Health insurance

Health savings account

Life insurance

Paid time off

Retirement plan

Vision insurance

Experience level :

2-4 Years of related experience. 4-6 year in credentialing.

Work Location : In person

In person