Job description
JOB SUMMARY
Responsible for managing the workflow of the provider coordinator team, oversees the maintenance of the provider panel, working with providers within pre-established guidelines, and supporting the onboarding of new providers.
Dane Street’s success relies on individual and team contributions every day. We care for our customers, each other and Dane Street. It is the responsibility for all of us to maintain a positive working environment that promotes client satisfaction and results.
MAJOR DUTIES & RESPONSIBILITIES
Provider Onboarding
- Ensure provider coordinator team operates in accordance with established processes and compliance standards.
Contract Processing
- Coordinate and review credentialing and contracting process Ensure new contracts are completed quickly and fee agreements are correct for current or new panel reviewers.
- Understand Client fee schedules and escalate provider agreement requests.
- Review the documentation in Salesforce on activities to ensure accurate information for reporting.
Panel Maintenance
Ensure the maintenance of provider profiles, including:
Provider profile instructions
Updated fees
Availability/scheduling
Doctor Group assignments
Credential expiration
Deactivating/Reactivating physicians
W9/ACH remit to changes
Documentation
- Use of Salesforce is a plus
- Attention to detail is required for a complete provider record
Onboarding for new providers, including but not limited to:
Oversee administrative tasks related to maintaining the provider panel.
Onboarding new providers based on client needs.
Obtain and process necessary paperwork, including:
Agreement
Application
CV
W9
ACH
Work with the Director of Operations to set fees for agreements.
DocuSign Coordination: Set up templates. Submit and track all required DocuSign documents and follow up as needed. Documents include:
Application
Agreement (specific for individual provider)
Client credentialing forms and supporting documentation
Training Documents: Submit training materials to all providers after signing the agreement and handle all follow-ups. Documents include:
VBA MDE TRAIN
LS Training Module List
Additional Support:
- Assist provider reviewers with technical or inquiries.
Other duties, mentoring & special projects, as assigned and based on business needs.
EDUCATION/CREDENTIALS:
An Associate’s Degree or Bachelor’s Degree is preferred.
JOB RELEVANT EXPERIENCE:
Provider credentialing and onboarding experience in a Healthcare/Insurance setting or equivalent transferable skill set.
Business experience in a healthcare and/or insurance setting is preferred.
JOB RELATED SKILLS/COMPETENCIES:
Working knowledge of physician networks, recruitment, credentialing, medical specialties and terminology. General knowledge of State and Federal compliance guidelines. Strong negotiation skills, communication skills, understanding of medical terminology, critical thinking, organizational skills, ability to manage time efficiently and to meet specific deadlines. Computer literacy and typing skills required.
WORKING CONDITIONS/PHYSICAL DEMANDS:
Any lifting, bending, traveling, etc. required to do the job duties listed above. Long periods of sitting and computer work.
WORK FROM HOME TECHNICAL REQUIREMENTS:
Supply and support their own internet services.
Maintaining an uninterrupted internet connection is a requirement of all work from home position.
This job description is subject to change at any time.
Join our team at Dane Street and enjoy a comprehensive benefits package designed to support your well-being and peace of mind. We offer a range of benefits including medical, dental, and vision coverage for you and your family. Additionally, we offer voluntary life insurance options for you, your spouse, and your children. We also offer other voluntary benefits which include hospital indemnity, critical illness, accident indemnity, and pet insurance plans. Employees receive basic life insurance, short-term disability, and long-term disability coverage at no cost. Our generous paid time off policy ensures you have time to relax and recharge, while our 401k plan with a company match helps you plan for your future. Apple equipment and a media stipend are provided for remote workspace.
ABOUT DANE STREET:
A fast-paced, Inc. 500 Company with a high-performance culture, is seeking insightful forward-thinking professionals. We process over 200,000 insurance claims annually for leading national and regional Workers’ Compensation, Disability, Auto, and Group Health Carriers, Third-Party Administrators, Managed Care Organizations, Employers, and Pharmacy Benefit Managers. We provide customized Independent Medical Exams and Peer Review programs that assist our clients in reaching the appropriate medical determination as part of the claims management process.
