The Provider Onboarding & Enrollment Specialist develops, executes and maintains standard operating procedures and protocols for provider onboarding and enrollment. This position serves as a one-stop shop, single-point-of-contact for physicians and advanced practice providers hired to serve in the organization. The Specialist provides exceptional customer service and project management for all activities required to begin employment and sets the foundation for long-term retention.
Develops, executes, and maintains standard operating procedures and protocols for provider onboarding and enrollment.
Supports Medical Group in delivering exceptional candidate, customer, and provider experience.
Establishes and maintains collaborative partnerships with the medical group leaders; demonstrates strong conflict resolution skills to ensure policies and procedures are followed without compromising candidate experience or engagement.
Collaborates across multiple organizational divisions including human resources, central business office, IT, marketing, operations, medical affairs and BMG finance to ensure seamless processes and timely start for providers.
Builds relationships and delivers seamless onboarding experience with providers to support retention outcomes throughout his/her first year as well as building rapport to influence outcomes with other internal departments.
Facilitates contract hand off with BMG finance - compensation manager - to ensure timely and accurate provider payments, including sign on bonuses, residency/fellowship stipends, and traditional payroll.
Collects and submits all required information and documentation for provider (re)enrollment with government payors and contracted Managed Care plans; Facilitates and works with 3rd party vendor, Managed Care and Central Business Office on provider enrollment processes including, but not limit to, new provider enrollments, on-going requests for updated documentation, attestations, enrollment statusing and verification.
Monitors enrollment tracking dashboard to ensure applications are being processed timely and provides any additional missing information as needed to complete enrollment. Communicates with internal stakeholders regarding status of enrollments.
Audits providers information for accuracy according to the necessary information required by various business units for internal standards and regulatory requirements.
Maintains complex databases and ensures confidential, complete and accurate data capture.
Minimum Education
Bachelor's Degree Business, Communication, Human Resource Management, Related field Required
Minimum Work Experience
5 years experience in healthcare Required
2 years experience in project management, relationship management and/or organizational development Required
Licenses and Certifications
Certified Professional Credentialing Specialist (CPCS_NAMSS) Certification through NAMSS within 2 Years Preferred
Required Skills, Knowledge and Abilities
Work independently, under minimal supervision and must possess the ability to manage across multiple projects simultaneously with critical thinking and independent judgement.
Ability to communicate, interface and relate to groups on all professional levels.
Must have above average analytical skills and ability to effectively prioritize competing priorities.
Proficient with use of computer software and productivity tools to accomplish individual and project objectives.
Excellent organizational skills and time management.
Global understanding of organizational development, change management and process improvements, principles and processes.
Superior oral and written communications skills.
Creative problem-solving skills.
Flexibility with non-traditional work hours and local travel.