The Provider Relations Outreach Coordinator is a critical position in developing and maintaining provider relationships. This position is responsible for working directly with Providers in researching and resolving provider issues both through structured outreach and resolution. This position is also responsible for phone outreach projects to educate providers on provider enrollment and credentialing requirements and other EOHHS policies.
Research and resolve provider escalation issues and manage work items through department queues. This will involve working closely with other departments including Provider Enrollment and Credentialing, Research, Call Center, and Quality Assurance as well as communicating with providers and other office staff to facilitate and resolve various escalation issues. This position must document within the MMIS and MassService system communication notes and resolution outcomes and close work items within department standards.
Outreach to provider offices via phone and email to support the revalidation initiatives. This position will call provider offices to obtain contact information, clarify provider structure, and identify affiliated providers. This position will also educate provider offices on the revalidation requirements including the POSC portal process and the proper submission of required documents. This position will outreach to provider contacts during the Waiting for Information (WFI) process to confirm that the provider understands what is missing from the revalidation documents. This position must document within MMIS and MassService communication system notes and resolution outcomes.
Educate provider offices via phone and email concerning the provider enrollment and credentialing process. This task involves educating provider offices on EOHHS policies and regulations for provider enrollment and credentialing and outreaching to provider contacts during the Waiting for Information (WFI) process on a regular basis to obtain missing information and documents to minimize application denials. This position must document clearly within MassService and MMIS system any communication with providers during the WFI process.
Support any department administrative requirements including preparing educational documents, organizing webinars, tracking participation in various educational sessions, and supporting other reporting needs.
Track record of accomplishments and ability to document communication and outcomes effectively
Excellent organizational, communication and interpersonal skills
Strong customer service experience, preferably in a provider services call center
Demonstrated leadership qualities
Comfortable working in a fast-paced environment
Proficient in Microsoft Office (PowerPoint, Word, Excel and Outlook
Preferred qualifications include: Knowledge of and experience with the MassHealth provider community and systems; knowledge of provider credentialing standards and requirements; an understanding of provider billing practices and claim processing