Business Office Liasion

Job Summary

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

Essential Job 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.
• Credits primary source verification. Ensure accuracy of all credentialing elements.
• Collects and validates documents. Assess 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.