Ancillary Coordinator

» Ancillary Coordinator
Information Technology
in Tampa
, FL
Reference: 19-03514

Description:

The Ancillary Coordinator coordinates and controls the workflow occurring in and out of the department. They track and review contracts and credentialing information within the unit. They coordinate with other functional departments as required.

Key Duties and Responsibilities:

  • Liaison between all cross-functional partners to communicate and resolve issues that arise between the departments
  • Track different types of requests coming into the department
  • Quality check integrity of all vendor self-reporting
  • Interact with all internal and external partners to drive timely deliverables and resolutions
  • Support day-to-day vendor interactions to ensure vendors are meeting all oversight deliverables in timely manner
  • Develop and communicate new compliance requirements and processes to internal team and partners
  • Review and track new contract requests and special projects as assigned
  • Ensure credentialing information is complete based on the requirements of the specific provider type
  • Review contract pricing and configuration to ensure the terms of agreement have been loaded accurately
  • Review contracts, addendums and amendments before sending to Finance for completeness and appropriate approval/signatures
  • Work with UM department to resolve authorization issues that impact ancillary provider networks
  • Administer the Sidewinder Tracking Application for the department and trains new employees on the tracking system
  • Troubleshoot claims issues with internal and external parties
  • Coordinate membership eligibility files and reviews capitation payments to vendors while assuring all applicable plan codes are appropriately loaded into the system
  • Resolve elevated member calls regarding eligibility files
  • Assist Provider Relations with questions in regards to paperwork submissions and contract issues
  • Research and resolve routine provider operational issues and questions
  • Track different types of requests coming into the department
  • Perform other duties as assigned

Education Level Required/Preferred:

  • An Associates degree in a related field required or equivalent work experience
  • A Bachelor’s degree in a related field preferred

Work Experience:

  • 2+ years of experience in a managed care environment with a focus on provider relations, configuration, credentialing, vendor oversight, vendor auditing, or related ancillary experience

Skill Sets:

  • Demonstrated written communication skills
  • Solid oral and written communication skills sufficient to clearly convey messages
  • Demonstrated interpersonal/verbal communication skills
  • Demonstrated analytical skills
  • Strong analytical and critical thinking skills
  • Ability to understand, interpret, and communicate provider contracts
  • Ability to understand regulatory guidance as it relates to provider reimbursement
  • Ability to follow direction

Technology Proficiency Required/Preferred:

  • Proficient in Microsoft Office such as Word, Excel, and Outlook