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SalaryPosition Summary:
The Provider Services Coordinator, Network Management is responsible for establishing and maintaining technical and operational system setup for the MedCost network provider database of information in MedNet. The position assists with provider database maintenance and notifying providers about changes with our database information. This includes maintenance of data that is populated in the MedCost.com provider directories for applicable areas of the network.
Position Responsibilities:
- Works to assure timely data entry of credentialed providers and facilities in MedNet;
- Coordinates with Reimbursement Team on installation of fees for new providers, practices and facilities to make providers effective timely;
- This includes effective date entry for new facilities, practices and providers in MedNet;
- Works with Network Management Team to ensure that delegated credentialing organizations submits quarterly updates of new physicians credentialed by their organizations and a complete database roster of their organization’s providers and conducts necessary outreach if not received;
- Notifies delegated contracted entities upon completion of data entry of provider information, providing them with a roster report of their information;
- Position pulls necessary information including directory form(s) so that Administrative staff can notify provider upon completion of entry of provider(s);
- Work to ensure timely data entry of changes and revisions to both the facility and physician data in MedNet, including making necessary changes, revisions, and/or terminations to update the MedNet system;
- Meets accuracy and quality standard goal of 97% per month as outlined in MedCost Performance Measures;
- Meets and/or exceed departmental goals including Performance Measures and OPSUM measurements;
- Completes special projects, as required;
- Proactively researches and resolves issues to avoid future escalation;
- Promotes MedCost strengths to the provider community whenever possible and represents the organization with integrity;
Required
- High school diploma/College graduate
- Minimum 1-2 years’ health care experience
- Working knowledge of the health care delivery system and the managed care environment;
- Strong interpersonal, verbal and written communication skills;
- Excellent organizational and time utilization skills;
- Provide accountability in a fair and respectful manner;
- Excellent PC skills with Microsoft Word, Excel, Access, PowerPoint and Outlook preferred;
- Ability to manage multiple items effectively with varying priorities;
- Detail and quality oriented;
- Ability to work with other departments and external clients in an efficient and congenial manner;
- Claims and Customer Service experience
- Ability to think and work effectively, anticipate needs and demonstrate resourcefulness;
- Ability to accurately complete tasks within established times;
- Provider background knowledge
- Service oriented
- Integrity
- Ethical practice and confidentiality
MedCost provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
MedCost participates in the Electronic Verification system (E-Verify) to electronically verify the work authorization of newly-hired employees. E-Verify is an internet-based program that compares information from an employee's Form I-9 to data contained in the federal records of the Social Security Administration and the Department of Homeland Security to confirm employment eligibility. MedCost does not use E-Verify to pre-screen job applicants.
