• Job Description

  Req#: 1015333
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  Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world’s leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage.
  Our work centers on creating an exceptional member experience – a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a consciously inclusive environment where diversity is celebrated.
  We are pleased to offer competitive salaries, and a benefits package with flexible work options, career growth opportunities, and much more.
  The Provider Enrollment Coordinator I is responsible for the processing and coordination of all provider enrollment transactions within the Provider Enrollment Portal (PEP), for monitoring and maintaining the data integrity of AllWays Health Partners’ provider data and directories and responding to provider letters of interest requests. S/he works with other AllWays Health Partners staff to update records, resolve provider configuration issues, and answer questions about provider enrollment transactions.
  
  
  Essential Functions
  • Process all provider enrollment transactions within the Provider Enrollment Portal (PEP), including all new ancillary and group contracts, new provider affiliations, open and close panel requests, terminations, and demographic changes.
  • Supports the completion of all enrollment transactions within department-specific turn-around-time standards.
  • Maintains and updates specific provider information directly in the claim processing system (QNXT).
  • Coordinates with Credentialing, Configuration, Member Services, and other PNM staff to process enrollment transactions, resolve enrollment issues, and track the progress of provider transactions through the entire enrollment process.
  • Maintains provider status lists for larger provider organizations and provides regular status reports to these groups.
  • Answer questions from various Mass General Brigham Health Plan staff concerning the status of provider enrollment transactions.
  • Regularly maintains department data quality standards concerning the data entry of all provider transactions. Corrects errors in data and continually looks for opportunities to improve the data integrity of Mass General Brigham Health Plan’s provider data and directories.
  • Works with the Contracting and Provider Relations staff to enroll new contracts and continually educates PNM staff on appropriate provider setup in the system.
  • Responds to Letter of Interest requests from new provider groups and coordinate the receipt of all required contract material from these provider practices.
  • Prepares final contracting documents for scanning and long-term storage.
  • Hold self and others accountable to meet commitments.
  • Ensure diversity, equity, and inclusion are integrated as a guiding principle.
  • Persist in accomplishing objectives to consistently achieve results despite any obstacles and setbacks that arise.
  • Build strong relationships and infrastructures that designate Mass General Brigham Health Plan as a people-first organization.
  • Other duties as assigned with or without accommodation.
  Working Conditions and Physical Effort
  • Work is normally performed in a typical remote office work environment.
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  Knowledge and Education
  • Bachelor’s degree or the equivalent combination of training and experience in related field.
  Experience
  Required:
  • 2-4 years administrative experience with at least 2 years in health care and/or insurance environment required, experience with provider enrollment preferred.
  Preferred/Desired:
  • Knowledge of insurance regulations and managed care contract policies.
  • Excellent people and project management skills along with excellent written, oral, and presentation skills.
  • Demonstrated competence in Microsoft Office, including Outlook, Word, Excel, and PowerPoint. Knowledge of the QNXT operating system preferred.
  • Ability to establish a rapport and interact well with individuals on all levels and to maintain a professional image and attitude.
  • Detail oriented, able to handle multiple tasks with excellent organizational skills and workplace flexibility.
  
  Skills/Competencies
  • Demonstrate Mass General Brigham Health Plan’s core brand principles of always listening, challenging conventions, and providing value.
  • Bring fresh ideas forward by listening to and working with employees and the people we serve.
  • Strong aptitude for technology-based solutions.
  • Ability to inject energy, when and where it’s needed.
  • Respect the talent and unique contribution of every individual, and treat all people in a fair and equitable manner.
  • Exercise self-awareness; monitor impact on others; be receptive to and seek out feedback; use self-discipline to adjust to feedback.
  • Be accountable for delivering high-quality work. Act with a clear sense of ownership.
  • Bring fresh ideas forward by actively listening to and working with employees and the people we serve.
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  Mass General Brigham is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.
  
  MGB Health Plan at Assembly Row (NHPAllwaysAssembly)
  399 Revolution Drive
  Somerville, 02145
  
  

• About the company

  Mass General Brigham is a Boston-based non-profit hospital and physicians network that includes Brigham and Women's Hospital and Massachusetts General Hospital, two of the nation's most prestigious teaching institutions.

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