Provider Coordinator, Team Lead

Dane Street, LLC; United States; Remote; USD 45,000 - 70,000; Full time

Job summary

Dane Street, LLC is seeking a Provider Coordinator to manage onboarding and credentialing within a healthcare context. The role involves ensuring compliance, maintaining provider records, and enhancing the efficiency of the provider coordinator team. A strong candidate will have relevant educational credentials and experience in a healthcare or insurance environment.

Benefits

Medical, dental, and vision coverage

Generous paid time off policy

401k plan with company match

Apple equipment provided for remote work

Voluntary life insurance options

Qualifications

• Provider credentialing and onboarding experience in a healthcare/insurance setting preferred.
• General knowledge of State and Federal compliance guidelines.
• Working knowledge of physician networks and medical terminology.

Responsibilities

• Oversee onboarding of new providers and coordinate credentialing processes.
• Maintain provider profiles and compliance documentation.
• Assist provider reviewers with inquiries and technical support.

Skills

Negotiation

Communication

Critical Thinking

Organizational Skills

Time Management

Education

Associate's Degree or Bachelor's Degree

Tools

Salesforce

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.