Support the overall day to day administrative and clinical activities of a multible provider rehabilitation center. Establish and maintain an effective operating enviornment which assures effective efficient and safe operations that responds to patient physician and staff needs. Key responsibilities will be:
1) Act as liaison between physicians and office employees to resolve conflicts and to promote cohesiveness in the practice; serve as liaison between the practice and other clinical and administrative components of Integrated Health And Injury Center (IHIC)
2. Ensure that the practice follows IHIC and office policies and procedures; adhere to and enforce JCAHO and OSHA standards relating to the physician office practice of medicine.
3. Monitor EHR proficiency of staff and providers; facilitate educational opportunities to maximize efficiency
4. Accurately report issues and concerns to appropriate personnel.
5. Serve as liaison between practice and IS staff.
6. Facilitate integration of new applications and/or upgrades as appropriate.
7. Monitor the submission of timely, accurate and complete billing information to the business office to ensure the maximization of professional services reimbursement; research disallowance reports for unusual reimbursement practices; remain up-to-date on coding and insurance practices as necessary and interact with the Central Business Office to update, change or delete codes and charges when determined to be ineffective, unprofitable and/or obsolete.
8. Registration and Charge Posting.
- Obtain new provider credentials, creating a credentials file and entering information into the credentialing database; update the provider’s CV
- Complete applications for medical licenses, DEA certificates, hospital privileges, occupational licensing, and managed care
- Enter license and certificate information into the credentials database
- File licenses and certificates into the credential’s files
- Provide licenses and certificates to requesting entities; respond to credentialing requests
- Maintain credentials files for providers by updating CVs, ensuring licenses and certificates are current, and confirming that CME requirements are met
- Interact and communicate with physicians and various Sonder Health Plans departments to obtain information necessary to complete all credentialing and re-credentialing activities.
- Interpret all NCQA (National Committee of Quality Assurance) guidelines, URAC (Utilization Review Accreditation Committee), as well as Federal and State health care program guidelines and then develop, revise and implement the appropriate credentialing and re-credentialing processes to adhere to these national guidelines.
- Obtain timely and accurate primary source verifications for all credentialing and re-credentialing activities.
- Maintain confidentiality of all pertinent and confidential provider information within credentialing and re-credentialing files.
- Complete provider enrollment for state agency participation with Medicare, Railroad Medicare, Medicaid, and Tricare. Act as a troubleshooter in resolving departmental issues related to credentialing and recredentialing.
- Manage and assign all applicable credentialing and re-credentialing office or facility site visits. Compile and maintain ongoing statistics regarding credentialing and re-credentialing to ensure 100% compliance with time sensitive materials.
- Conduct/attend all required department and company meetings and complete all mandatory education/training
Job Type: Full-time
Pay: From $52,000.00 per year
- Dental insurance
- Employee discount
- Health insurance
- Paid time off
- Referral program
- Physical & Rehabilitation Medicine
- 8 hour shift
Staff and patients are required to wear facial mask at “ALL TIME” when entering the facility! Sanitizing disinfecting and Covid-19 cleaning procedures are in place and enforced!
- One location
Typical start time:
Typical end time:
This Job Is:
- A “Fair Chance” job (you or the employer follow Fair Chance hiring practices when performing background checks)
- Waiting period may apply
- Only full-time employees eligible
- Temperature screenings
- Social distancing guidelines in place
- Sanitizing, disinfecting, or cleaning procedures in place
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