Provider Onboarding Specialist

POSITION SUMMARY:

Oversees the best practice model to ensure a smooth, welcoming transition and integration of providers into the BMC Community. Under the supervision of the Credentialing Operations Manager, leads the coordination of the onboarding of new billing providers at the time of hire and the offboarding of billing providers at the time of departure. Executes and facilitates tasks related to onboarding and gathering and disseminating of information to appropriate administrative stakeholders to ensure a timely start of clinical duties for new Billing Providers. Executes and facilitates tasks to ensure appropriate actions are performed at the time of provider departure facilitating exceptional quality of patient care without exception. Onboarder/Offboarder Specialist verifies data obtained from the provider and internal and external parties is documented in the computer software systems, provides information to requesting departments, hospitals, agencies; develops and implements new systems and procedures, as necessary. Plans, coordinates, delegates and performs administrative activities for the Medical Affairs and Payer Enrollment Departments.

Position: Provider Onboarding Specialist

Department: Operations

Schedule: Full Time

ESSENTIAL RESPONSIBILITIES / DUTIES:

Requires impeccable professional conduct and customer service skills. Exhibits a professional, welcoming, positive impression of Boston Medical Center to internal, external clients and providers. Ensures applications for licensing (including Massachusetts Controlled Substance and DEA), credentialing and payer enrollment are completed and submitted by the new provider. Responsible for tracking status of new provider's application and working collaboratively with Medical Affairs and Payer Enrollment. Collaborates with various internal stakeholders and external stakeholders to obtain all required information necessary to complete provider's file. Communicates with new provider, departmental management, directors and internal departments regarding status and completion of data. Verifies key tasks are performed timely in relation to providers clinical start date and termination date. In coordination with Medical Affairs and Payer Enrollment, communicates known or anticipated delays in the new billing providers start date. Provides status of new provider onboarding and provider termination at regularly scheduled intervals or upon request

Onboarding Responsibilities:

• Verifies key tasks required prior to start of clinical duties are completed timely and the provider is ready to bill by performing directly, delegating or confirming other key stakeholders have completed the tasks required.
• Ensures all pre-employment requirements are met, including but not limited to, pre-employment paperwork, salary letter and agreement (when applicable), physical exam, human resource paperwork.
• Eliminate repetition in data and signature requests to provider, whenever possible.
• Responsible for performing the following tasks; maintains Morrisey system as the source of truth for all applicants, active and terminated Billing Providers, ensures data provided by various sources and copies of Salary Letter and Agreement are maintained in the Morrisey system and verify faculty appointment packet is completed timely.

Offboarding Responsibilities:

• Verifies key task are completed timely relative to providers termination date by performing directly, delegating or confirming other key stakeholders have completed the tasks required. Tasks include but are not limited to deactivating access to systems, badge, email and token.
• Verifies resignation letters are stored, various stakeholders are notified of termination, verify if privileges are to be maintained after termination, verify appropriate parties are notified so necessary action can be taken for outstanding clinical documentation.

Other Responsibilities:

• Acts as a liaison between the provider and both internal and external departments/vendors.
• Maintains communications; establishes and maintains positive working relationships with employees, providers, clients, regulatory
• agencies, vendor and the public.
• Maintains working knowledge of Bylaws, Hospital Rules and Regulations, government regulations, NCQA Credentialing guidelines.
• Performs other duties as assigned by the Credentialing Operations Manager.
• Works in a highly collaborative manner with Credentialing Operations Manager and the Physician Enrollment Manager to ensure workflow is seamless between the Onboarder/Offboarder Lead and Credentialing/Enrollment coordinators.
• Prepares reports to monitor department compliance and internal metrics for quality and timeliness.
• Participates in Quality Improvement teams, as required, examining processes and automation techniques in order to make systems more efficient.
• Maintains accurate records and data for each Billing Provider in the Morrissey credentialing software system. Updates records and develops reporting procedures.
• Prepares reports, completes surveys and questionnaires for hospital administrators, chiefs of clinical divisions/departments in addition to other agencies and institutions as required.
• Produces lists and reports for departments within Boston Medical Center and other institutions and agencies where appropriate. Performs other related duties as required.

JOB REQUIREMENTS

EDUCATION:

• Associate's degree required, bachelor's degree preferred.

EXPERIENCE:

• Applicants must have at least five (5) years of full-time or equivalent part-time, experience in a healthcare environment.
• A bachelor's degree in information systems or previous database administrator experience may be substituted for a maximum of two (2) years of the required experience.
• Experience in a group practice, Medical Staff Office (or equivalent) or credentials verification organization or health plan preferred.

KNOWLEDGE AND SKILLS:

• Requires impeccable professional conduct and customer service skills

Compensation Range:

This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensures as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), discretionary annual bonuses and merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family well-being.

NOTE: This range is based on Boston-area data, and is subject to modification based on geographic location.

Equal Opportunity Employer/Disabled/Veterans

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