Office Support Specialist I

Office Support Specialist I

The Department of Public Health (DPH) at Tewksbury Hospital is looking for a Credentialing Office Support Specialist I to join its team. This role is responsible for overseeing provider enrollment and access within the Centers for Medicare & Medicaid Services (CMS) Provider Enrollment, Chain, and Ownership System (PECOS) after clinicians have been credentialed and granted medical staff privileges. The Credentialing Office Support Specialist coordinates federal and state provider enrollment activities to ensure compliance with CMS and MassHealth requirements.

Duties and Responsibilities (these duties are a general summary and not all inclusive): Create and maintain individual provider enrollment accounts for Individual Provider Enrollment (CMS-855I) and Reassignment of Benefits (CMS-855R). Set up provider access and ensure accurate enrollment in the CMS/PECOS system. Enter and maintain provider demographics and practice location information. Process reassignment of benefits to the appropriate group practice. Upload and maintain all required credentialing and enrollment documentation. Coordinate and obtain provider approval signatures on enrollment applications and supporting documents. Collaborate with the Fiscal/Billing department to ensure accurate provider enrollment, reimbursement setup, and payer compliance. Coordinate MassHealth enrollment for non-billing providers, including assisting with individual provider contracts for Ordering, Referring, and Prescribing (ORP) providers. Monitor and ensure completion of required five-year revalidation for CMS and MassHealth provider enrollments to maintain active participation. Track enrollment application status, respond to requests for additional information, and resolve issues with CMS, MassHealth, and Medicare Administrative Contractors (MACs). Offboard departing clinicians by terminating or updating CMS and MassHealth enrollments, ending reassignment relationships, and removing applicable system access in accordance with organizational policies. Maintain accurate provider enrollment records and ensure compliance with federal, state, payer, and organizational credentialing standards. Assist with the coordination the DPH Practitioner's Schedule for the Department of Medicine Takes minutes at Committee meetings and other meetings assigned

Required Qualifications: Ability to communicate effectively Ability to multi-task and prioritize Ability to assist customers of diverse backgrounds Knowledge of software applications such as desktop publishing, project management, spreadsheets, and database management.

About the Department of Public Health: The mission of the Massachusetts Department of Public Health (DPH) is to prevent illness, injury, and premature death, to assure access to high-quality public health and health care services, and to promote wellness and health equity for all people in the Commonwealth. We envision a Commonwealth in which all people enjoy optimal health.

Qualifications: First consideration will be given to those applicants that apply within the first 14 days. Office Support Specialist I: Applicants must have at least (A) two years of full-time, or equivalent part-time, experience in administrative work experience or (B) any equivalent combination of the required experience and the substitutions below: Substitutions: I. An Associate's or higher degree with a major in business administration, business management or public administration may be substituted for the required experience. II. An Associate's or higher degree with a major other than in business administration, business management or public administration may be substituted for a maximum of one year of the required experience. Education toward such a degree will be prorated on the basis of the proportion of the requirements actually completed. Educational substitutions will only be permitted for a maximum of two years of the required experience.

Primary Location: United States-Massachusetts-Tewksbury-365 East Street

Job: Administrative Services

Agency: Department of Public Health

Schedule: Full-time

Shift: Day

Salary: 57,865.34 - 81,582.28 Yearly