Business Office Liasion (67696)

“Sanitas is a global healthcare organization expanding across the United States. Our services include primary care, urgent care, nutrition, lab, diagnostic, health care education and resources for our patients. We strive to attract professionals who believe in our mission, vision and are dedicated to the service of our patients and their families creating a memorable experience through compassion, respect, and kindness.”

Job Summary

The Business Office Liaison will assist various business office departments by performing the executive and administrative duties as assigned.

Essential Job Functions

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Evaluates, analyzes, and coordinates all aspects of the credentialing and re-credentialing processes for practitioners practicing within the Sanitas Health System clinical entities.
• Communicates clearly with providers, their liaisons, entity Medical Staff Affairs. Medical staff leadership and Administration, as needed.
• Identifies, analyzes and resolves extraordinary information, discrepancies, time gaps and other idiosyncrasies that could adversely impact ability to credential and enroll practitioners.
• Discovers and conveys problems to Revenue Cycle - Credentialing Manager and entity Medical Staff Affairs.
• Provide timely responses upon request on day-to-day credentialing and privileging issues as they arise.
• Sound decision making in accordance with Medical Staff Bylaws, credentialing policies and procedures, federal, state, local and government/insurance agency regulations.
• Conducts primary source verification. Ensure accuracy of all credentialing elements.
• Collects and validates documents. Assesses completeness of information and qualifications relative to credentialing standards and Sanitas Health System criteria.
• Establishes and maintains effective communication with third party billing, other healthcare providers, insurers, and patients/families.
• Performs complex patient accounting tasks in ECW requiring specialized knowledge of third-party payer requirements and other patient accounting rules and regulations.
• Secure accurate and pertinent information to maximize reimbursement.
• Documentation intake - email all onboarding providers a list and link to upload the listed needed documents to Medtrainer. Review documents for completeness.
• Malpractice COI application submission - Email the insurance vendor the provider's CV, and Certificate of Insurance application.
• Sanitas Credentialing system update - audit Medicred and Medtrainer for completeness.
• Pharmacy project - Send providers dispensing medication registration forms for completion.
• Obtaining privileges for Medical Directors - Review privileges forms for completeness, upload all pertinent documentation.
• HR Credentialing Committee Meeting - Prepare Monthly agenda, include CVO files for committee to review. Review any providers with cases and bring cases up to the committee.