What are the responsibilities and job description for the Managed Care Coordinator position at Wyckoff Heights Medical Center?
Under the general supervision of the Director of Credentials, with independent decision making, will assist in the management of and serve as a liaison between the Managed Care/Provider Enrollment Department of Wyckoff Heights Medical Center and its various Insurance Carriers to enroll Providers into various participating plans of the Medical Center. Will perform all duties in a manner consistent with Wyckoff Heights Medical Center’s commitment to providing superior patient care and promoting good guest relations.
* Coordinates with the Credentials Department for credentialing reports to the delegated health plans as mandated in the delegation agreements.
* Coordinates with the Credentials Department for the delegated health plans annual audits.
* Verifies providers have been uploaded into the Plans’ systems and obtains ID numbers.
* Preparation, submission, and follow-up of provider applications for non-delegated health plans.
* Reporting of all additions, terminations, and changes to the delegated health plans as needed but no less than monthly, and maintaining proof of these submissions.
* Update and maintain provider’s CAQH profile
* Preparation, delivery, and (after completion) collection of provider enrollment packet to new provider.
* Performs all other duties as required by the department with relations to Managed Care and Provider Enrollment.
* Answers calls, mailings.
* Ad hoc reporting as needed.
* Processes files of terminated providers for archiving.
* Assists in building and maintaining the Apogee Database.
* Coordinates with the Director of Credentials to create and update Provider Enrollment policies and procedures.
* Performs maintenance and updates of provider credentials for continued participation in Health Plans.
Position Requirements:
* This position requires a minimum formal education of High School Diploma or equivalent and a minimum of 3 years job-related experience.
* Desired (not required) criteria include: Effective verbal, written, and organizational skills. Knowledge of CMS, NCQA, State and Federal regulations related to health plan credentialing activities. Computer knowledge, including working knowledge of Microsoft Office & MSOW Credentialing Software, CPCS OR CPMSM certification preferred.
* Self-starter and self-motivated, functions independently with minimal direction. Maintains professional demeanor and confidentiality. Flexible, team player. Must be able to work with a variety of people and circumstances.
Job Type: Full-time
Pay: $30.00 - $32.00 per hour
Benefits:
- Dental insurance
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Tuition reimbursement
- Vision insurance
Schedule:
- 8 hour shift
- Day shift
- Monday to Friday
Work setting:
- In-person
- Office
Ability to commute/relocate:
- Brooklyn, NY 11237: Reliably commute or planning to relocate before starting work (Required)
Experience:
- Customer service: 1 year (Preferred)
Work Location: In person
Salary : $30 - $32