Market Access Operations Coordinator

BioReference Health, LLC•Elmwood Park, NJ

About The Position

The Market Access Coordinator is responsible for supporting payer relationships, commercial and government, nationwide or within an assigned territory. Reporting to the Market Access Operations Manager, the Coordinator manages the administrative aspects of the payer relationship. Such responsibilities include, but are not limited to: credentialing, enrollment, fee schedules, data exchange (i.e. HEDIS), as well as act as liaison with the legal counsel for contract revision, signature, documentation and record retention all in accordance with the core values of BioReference Health, LLC. PRINCIPAL JOB DUTIES: Duties may include but are not necessarily limited to the following: Supporting the overall strategy of the company with health plans and payers to achieve short-term and long term goals. This includes: Proactively reviewing health plan credentialing and enrollment documents and health plan reimbursement trends Aligning with the company value proposition appropriately. Develop and support administrative relationships with the Market Access Directors and Managers to drive in network coverage decisions and fair reimbursement. Involvement with the development of processes for efficient day to day payer support and support client facing (Sales) inquiries. Maintain exceptional documentation and record retention for future contract negotiations and reference. Escalates potentially problematic issues to management as it relates to payer contracting and enrollment (i.e. official payer correspondence). Provide education and training to sales as it relates to payer relations and managed care (government and commercial). Work effectively with individuals across multiple departments throughout the organization. Embrace, embody and represent the BioReference Health, LLC company culture at all times to external and internal constituents. Demonstrate the values of the company by acting with integrity, respect and trust. Other duties as assigned EDUCATION: HS Degree is required College is preferred EXPERIENCE AND REQUIRED SKILLS: 2+ years of experience in the health care provider setting (medical billing or medical assistant) Ability to manage multiple priorities simultaneously. Credentialing experience Keen understanding of managed care and health plan operations Ability to work independently, communicate proactively, manage multiple projects and prioritize daily tasks while managing critical deadlines. Excellent communication, customer service skills and organizational skills. Ability to handle sensitive information and maintain a very high level of confidentiality. Must be proficient with all Microsoft Office products -- particularly Excel and Word BioReference is an Equal Opportunity Employer Qualifications This is an exciting time to join our dynamic organization! BioReference, an OPKO Health company, is the largest full service specialty laboratory in the United States that gives healthcare providers and patients the power to make confident healthcare decisions. With a focus on oncology, urology and women's health, BioReference offers comprehensive test solutions and unparalleled expertise based on a 40 year legacy of proven science and exceptional service. Join our team and become part of the journey in making our patients and customers the highest priority.

Requirements

2+ years of experience in the health care provider setting (medical billing or medical assistant)
Ability to manage multiple priorities simultaneously.
Credentialing experience
Keen understanding of managed care and health plan operations
Ability to work independently, communicate proactively, manage multiple projects and prioritize daily tasks while managing critical deadlines.
Excellent communication, customer service skills and organizational skills.
Ability to handle sensitive information and maintain a very high level of confidentiality.
Must be proficient with all Microsoft Office products -- particularly Excel and Word
HS Degree is required

Nice To Haves

College is preferred

Responsibilities

Supporting the overall strategy of the company with health plans and payers to achieve short-term and long term goals. This includes:
Proactively reviewing health plan credentialing and enrollment documents and health plan reimbursement trends
Aligning with the company value proposition appropriately.
Develop and support administrative relationships with the Market Access Directors and Managers to drive in network coverage decisions and fair reimbursement.
Involvement with the development of processes for efficient day to day payer support and support client facing (Sales) inquiries.
Maintain exceptional documentation and record retention for future contract negotiations and reference.
Escalates potentially problematic issues to management as it relates to payer contracting and enrollment (i.e. official payer correspondence).
Provide education and training to sales as it relates to payer relations and managed care (government and commercial).
Work effectively with individuals across multiple departments throughout the organization.
Embrace, embody and represent the BioReference Health, LLC company culture at all times to external and internal constituents.
Demonstrate the values of the company by acting with integrity, respect and trust.
Other duties as assigned