Provider Onboarding Specialist

South Portland, ME

Full Time

Administrative

Mid Level

POSITION SUMMARY
Position delivers superior provider onboarding experience to Synergy physicians by delivering a high level of customer service and maintaining quality throughout the onboarding process from the time the provider contract is signed, until after the provider begins employment. This role ensures timely completion of credentialing, payor enrollment, onboarding activities and ongoing monitoring according to State, Federal, external accreditation agency, and health plan requirements. Additionally, this position may be responsible for a myriad of payor enrollment functions, including application processing and follow-up.

Candidate must currently reside in Maine.

ESSENTIAL FUNCTIONS

Responsible for the timely completion of the full cycle onboarding process for Synergy physicians in our busy multi-specialty healthcare setting.
Responds to all physician/provider inquiries while delivering a top-notch service facilitated through multiple communication channels
Works collaboratively within a cross-functional team of credentialing professionals to provide full-service solutions to providers and the Company
Works collaboratively with Payor Contracting, Finance, Revenue Cycle Management, HR and clinical operation to support billing and credentialing for the company
Provides support to practitioners for Maintenance of Certification requirements, including reminders and assistance with data entry.
Facilitates credentialing and privileging for clinical providers (physicians and various mid-level providers) across multiple healthcare facility sites of service
Self-directs the preparation and submission of applications on behalf of new and existing providers in a time-sensitive manner
Gathers, compiles, analyzes, and evaluates provider-specific information based on the requirements of each healthcare facility with strict attention to accreditation standards
Works collaboratively with Risk Management in meeting Board of Licensure or facility reporting requirements
Maintains knowledge of new and changing accreditation, licensing, and educational requirements
Maintains upkeep and accuracy of all documentation in provider credentialing files; ensures documentation is current, organized, and in compliance with records retention policies
Maintains good working relationships and open communication channels with internal and external customers including providers, specialty practices, leadership, healthcare facilities, state and federal agencies

PRIMARY RESPONSIBILITIES
• Organizes and prioritizes workload and facilitate multiple projects within assigned deadlines

Maintains personal adherence to professional and confidentiality standards established within the department and in accordance with legal, ethical and internal policies
Documents provider data and application tracking as part of a comprehensive credentialing database; enters new data and updates existing records as appropriate
Adheres to credentialing policies and procedures
Performs other credentialing, privileging and licensing duties as assigned, including as payor enrollment, maintenance of Certification tracking, and off-boarding
Attends meetings as assigned and participates in educational activities to keep skills up to date
Demonstrates professionalism at all times
Displays cooperative behavior and interacts positively and effectively with others to promote a team environment
Performs other duties necessary to maintain the overall efficiency and continuity of the dept
Is proactive in identifying, reporting and participating in the resolution of any potential or safety issues

QUALIFICATIONS

Bachelor’s degree or equivalent in relevant work experience: 3+ years’ credentialing and knowledge of privileging in the healthcare field
Professional certification through the National Association of Medical Staff Services as Certified Provider Credentialing Specialist (CPCS) encouraged
Demonstrates a high degree of technical proficiency in current Microsoft Windows environment, relational databases (SAS, Access), spreadsheets, word processing, presentation slides, electronic documents and e-mail systems
Knowledge in the areas of medical staff services administration, credentialing processes, privileging, risk management, and information management
Ability to communicate sensitive information and address difficult situations with tact and diplomacy
Excellent verbal and written communication skills, including the ability to craft complex business correspondence
Demonstrates service excellence, detail orientation, superb organizational skills, follow-through, and analytical ability/skills
Communicates effectively and professionally with physicians, leadership and other staff at all times
Ability to use creative problem-solving as part of an otherwise standardized and regulated process
Ability to work independently and as a member of the team
Excellent customer service skills
Ability to maintain confidentiality

PHYSICAL DEMANDS / WORK ENVIRONMENT

Operation of various office equipment; fax machine, telephone & voice mail system, stationary/lap top computer, , scanner, e-mail system, cell phone, and copier
Requires prolonged sitting, keyboarding and repetitive reaching
Light lifting of paperwork, folders or other general record keeping materials
Occasional travel to various locations for meetings or professional development events

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