Paralegal

SUMMARY:

• Dual Roles:
• 1. Coordinates physician and allied health professional credentialing and enrollment
• activities with Medicare, hospitals, health plans, and other regulatory organizations. This
• role prepares and submits credentialing applications, maintains credentialing records, and
• supports physicians’ medical and DEA license renewals, CME tracking, and re
• credentialing as needed.

• 2. First-line review for all contracts in support of Executive Administrator (J.D.) including
• maintaining terms and conditions of all contracts in a contract management program.

• Primary Responsibilities
• 1. Prepares and submits initial/on-boarding credentialing and re-credentialing enrollment applications
• for physicians and allied health professionals with hospitals, health plans, Medicare, and
• commercial insurance carriers.
• 2. Ensures the Medicare enrollment status for each physician and the entity is complete, accurate,
• and up-to-date at all times. Responds timely to any and all correspondence received from
• Medicare.
• 3. Submits new provider information and updates to the National Provider Identifier (NPI) registry and
• Council for Affordable Quality Healthcare (CAQH).
• 4. Maintains credentialing files for physicians and allied health professionals including licenses, CME,
• certifications and regulatory documentation. Monitors expiration dates for provider licenses, Drug
• Enforcement Administration (DEA) registrations, professional liability insurance, and specialty
• board certifications. Prepares and submits renewal applications and documentation prior to
• expiration deadlines.
• 5. Maintains complete, accurate, and up-to-date documentation of provider enrollment records with
• Medicare and managed care entities.
• 6. Assists all department managers/directors by providing first-line review of all contracts in a manner
• that is consistent with the entity’s standards and Executive Administrator’s expectations. Coaches
• managers on negotiating tips for requested changes on contracts. Such contracts include, but are
• not limited to:
• i. Employment agreements;
• iil Equipment and building maintenance;
• III. Equipment and building leases;
• iv. Bank loans and mortgage loans;
• v. Software support services;
• vi. Contracts with payors and managed care organizations;
• vii. Supplier contracts; and
• viii. Service agreements

• 7. Assists in identifying and handling start-up implementation for a contract management system.
• 8. Maintains all data in contract management system and follows-up as needed on tracking and
• maintaining finalized, fully executed contracts. Enters all terms and conditions in contract
• management system including, but not limited to, terms of contract, renewal terms, termination
• terms and notice periods/process, price escalation agreements, and insurance requirements
• including current proof of insurance.
• 9. Performs all other duties as assigned.

• Education and Experience
• •Associate degree in Paralegal Studies or related field required; Bachelor’s degree in Paralegal
• Studies preferred.
• •ABA-approved paralegal certificate required.
• •Experience with physician credentialing, Medicare enrollment, and healthcare administration
• required.
• •Experience with contract review, management, and negotiation required.

• Required Skills and Abilities
• •Strong organizational and time management skills.
• •Strong attention to detail
• •Effective written and verbal communication skills.
• •Ability to maintain confidential and sensitive information.
• •Ability to coordinate multiple tasks and deadlines simultaneously.
• •Strong customer service skills when interacting with physicians, management team, and
• administration.
• •Professional interpersonal skills with the ability to interact effectively with leadership,
• physicians, and peers.
• •Proficiency in Microsoft Office (Word, Excel, Outlook, and PowerPoint).

• Physical Requirements
• •Ability to sit for extended periods while working at a computer workstation;
• •Frequent use of hands and fingers for typing, data entry, and phone use;
• •Ability to speak clearly and hear well enough to communicate by phone and in person;
• •Occasional standing, walking, bending, and reaching;
• •Ability to lift and carry up to 25 pounds (files, office supplies);
• •Visual acuity to read computer screens; and
• •Ability to focus for long periods and manage high-volume, detail-oriented tasks.