EAP Operations Specialist
Job ID: 176426
Category: Clerical/Administrative
Work Type: FT
Location: Philadelphia, PA, United States
Date Posted: Apr 10, 2023
Description
Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?
Summary:
- The EAP Operations Specialist provides operational support, including provider network support, member support, and finance support, for Penn Medicine EAP with offices in Philadelphia and Princeton. (Penn Behavioral Health - Philadelphia, PA)
Responsibilities:
- Provider Network Support
- Setup
- Credentialing
- Monitor providers that require re-credentialing using EAP Expert.
- Credential any new providers that come in.
- Create “review packets”.
- Send the “review packets” to the Credentialing Committee. Track, follow up and steward “review packets” final decision.
- Set up new credentialed providers in EAP Expert
- Provider files
- Ensure all providers are registered on and trained to use the provider portal.
- Authorizations
- Generate authorizations for members with appointments and send to Provider files.
- Support
- Act as “go to person” for network providers.
- Manage Alerts in Provider files for providers not accepting appointments.
- Member Support
- Process intake and setup appointments with EAP clinicians using the EAP Expert calendar
- Serve on project to create a single 800 number, single ACS system and single answering Service
- Project member.
- At end of project serve as process owner.
- Ensure all delivered answering service messages are actioned by EAP Clinicians.
- Actively reach out to members who have not requested authorizations within one week with appropriate follow up.
- Finance Support
- Follow up on any missing or expired Lawson numbers or provider rates.
Credentials:
Education or Equivalent Experience:
- H.S. Diploma/GED (Required)
- 2+ years Medical office experience, or 4 years of customer service experience. Advanced degree (Associate's, Bachelor's, Master's) may be considered in lieu of experience
Live Your Life's Work
We are an Equal Opportunity and Affirmative Action employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.
