MAXIMUS

Provider Relations Coordinator

US-MA-Boston
4 days ago
Requisition ID
2017-26840
# of Openings
1
Job Function
Outreach
Job Schedule
Regular Full-Time

Overview

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.  

Responsibilities

  • 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.                                                                             

The Ideal Candidate will Possess the Following Additional Education and Experience

  • Bachelor's degree from an accredited college or university required, preferably in Healthcare field
  • 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

EEO Statement

EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies MAXIMUS deems essential, and bring a resiliency and dependability that greatly enhances our workforce. We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a difference for our country. We’re proud of our connections to organizations dedicated to serving veterans and their families. If you are transitioning from military to civilian life, have prior service, are a retired veteran or a member of the National Guard or Reserves, or a spouse of an active military service member, we have challenging and rewarding career opportunities available for you

A committed and diverse workforce is our most important resource.

MAXIMUS is an Affirmative Action/Equal Opportunity Employer.

MAXIMUS provides equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disabled status.

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