Job Description

Job Summary:

Responsible for obtaining necessary information and documentation to enable the submission of third-party payer applications and contracts. Performs the necessary follow-up to confirm physician provider numbers have been assigned by payers and are logged into the Morrisey credentialing system. Responsible for maintaining physician payer application records and training new staff on payer application process. Maintains good business relationships with payers to facilitate payer application process. The position serves as the coordinator for the payer application process for employed physicians and voluntary physicians as requested for all operating units and Care New England Medical Group.

Duties and Responsibilities:

Working in conjunction with the provider on-boarding team, responsible for coordinating, processing, and maintaining initial payer application information and documentation for new/established/voluntary and CNEMG practitioners utilizing the Morrissey credentialing system.

Process payer re-credentialing information as requested (initial applications are priority).

Maintain and update CAQH database as necessary for processing applications and recertification of provider as required.

Develop and maintain relationships with key contacts with payers and internal departments (especially Medical Staff office and clinical departments).

Monitor payers for updates/modifications to their credentialing process and documentation; Communicate changes to appropriate staff.

Daily, documents and resolves issues in a timely manner, consistent with established department standards.

Participate in task forces and/or other meetings as assigned and execute other responsibilities (including administrative assistant duties) as assigned.

Performs other job-related duties as assigned or directed.

Requirements:

Associates degree preferred with one to three years of experience in secretarial functions.

At least one year of experience in dealing with physicians, hospitals and managed care organizations, or equivalent combination of education and experience.

Must have exceptional interpersonal skills, telephone etiquette, written communication skills.

Experience in physician payer credentialing, physician practice management and physician billing procedures are preferred.

Care New England Health System (CNE) and its member institutions, Butler Hospital, Women & Infants Hospital, Kent Hospital, VNA of Care New England, Integra, The Providence Center, and Care New England Medical Group, and our Wellness Center, are trusted organizations fueling the latest advances in medical research, attracting the nation’s top specialty-trained doctors, and honing renowned services and innovative programs to engage in the important discussions people need to have about their health.

Americans with Disability Act Statement: External and internal applicants, as well as position incumbents who become disabled must be able to perform the essential job-specific functions either unaided or with the assistance of a reasonable accommodation, to be determined by the organization on a case-by-case basis.

EEOC Statement: Care New England is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status

Ethics Statement: Employee conducts himself/herself consistent with the ethical standards of the organization including, but not limited to hospital policy, mission, vision, and values.

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