Provider Coordinator, Team Lead

Summary

Join Dane Street's provider coordinator team and manage the workflow, maintain the provider panel, onboard new providers, and ensure compliance with established processes and standards. You will coordinate and review the credentialing and contracting process, ensuring timely completion of new contracts and accurate fee agreements. Maintain provider profiles, including updating fees, availability, and handling credential expirations. Oversee administrative tasks related to maintaining the provider panel and onboarding new providers based on client needs. Process necessary paperwork, coordinate DocuSign documents, and submit training materials to providers. Assist provider reviewers with technical inquiries and participate in other duties and special projects as assigned. The role requires strong negotiation, communication, and organizational skills, along with knowledge of medical terminology and compliance guidelines. Dane Street offers a comprehensive benefits package including medical, dental, vision, life insurance, paid time off, a 401k plan, and more.

Requirements

• Provider credentialing and onboarding experience in a Healthcare/Insurance setting or equivalent transferable skill set
• 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

Responsibilities

• Ensure provider coordinator team operates in accordance with established processes and compliance standards
• 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
• 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
• 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

Preferred Qualifications

• An Associate’s Degree or Bachelor’s Degree is preferred
• Business experience in a healthcare and/or insurance setting is preferred

Benefits

• Medical, dental, and vision coverage for you and your family
• Voluntary life insurance options for you, your spouse, and your children
• Other voluntary benefits which include hospital indemnity, critical illness, accident indemnity, and pet insurance plans
• Basic life insurance, short-term disability, and long-term disability coverage at no cost
• Paid time off
• 401k plan with a company match
• Apple equipment and a media stipend are provided for remote workspace