Lead Provider Enrollment Coord - MyMichigan Health

Summary:

*This position has the opportunity be on site, remote, or hybrid.*

 

This position is responsible for all training of new and established employees in coordinating and completing provider enrollment activities for enrolling new and Locum Tenens providers. This also includes training on all re-credentialing activities for existing providers within the Physician Enterprise, communicating with providers, payers, Practice Managers, Physician Recruitment, Central Verification Office and Administration on issues and progress of enrollment activities. The timeliness and quality of the enrollment process has direct financial impact on the Physician Enterprise in addition to impacting provider and patient satisfaction. The Provider Enrollment Lead will be responsible for maintaining Cactus with accurate provider information, as well as submission of provider files to requesting payers. They will be responsible for maintaining Group NPI’s by TIN and making any necessary changes to the 855’s. The Provider Enrollment Lead will be responsible for any special projects brought forth and will serve as a resource for the Provider Enrollment team, providing guidance in all enrollment duties. They will be responsible for creating and maintaining all training materials and requires a broad knowledge of current payer enrollment requirements. The Lead must be able to work independently and make decisions based on their broad knowledge on the enrollment process. This position will also provide coverage as needed

Responsibilities:

(30%)* Develops and facilitates all administrative activities related to the provider enrollment process ensuring their accurate and timely completion. Keeps team members and other stakeholders informed of any payer changes in regards to enrollment. Requires excellent organizational, communication and computer skills.

 

(30%)* Acts as a resource to the enrollment coordinators in the complex provider enrollment process, has the authority to make independent decisions within the scope of responsibilities and in accordance with provider enrollment policies and procedures through analyzing, comparing, and evaluating various courses of action.

 

(20%)* Coordinates education and training for new and established provider enrollment employees. Develops and maintains all training materials.

 

(10%)* Demonstrates competency in the Visual Cactus database to conduct queries, creation, and production of reports.

 

(10%)*Any other projects as assigned.

 

OTHER DUTIES AND RESPONSIBILITES:

Demonstrates excellent interpersonal, problem-solving, and communication skills, both written and oral.

 

Ability to work effectively, cooperatively, and professionally with diverse groups of providers, and other administrative staff to ensure that enrollment activities are completed in a timely manner.

 

Supports the Physician Enterprise as needed on short-notice provider start-ups, prioritizing workload to support revenue goals.

 

Must be extremely accurate and detail oriented.

 

Must be able to exercise good judgement and work under pressure, with strong time management skills.

 

Maintain Epic work queues related to provider enrollment and related enrollment issues.

 

Serves as a major resource for providers, office staff, management, administration and payers for provider enrollment activities.

 

All other projects and duties as assigned. 

Certifications and Licensures:

N/A

Required Education:

Education: Bachelors Degree

 

Comments: Bachelor's degree in business or health-related field or equivalent experience is required. Additionally, Provider Enrollment Specialist certification is required with in 1 year of hire or transfer date.

Other Information:

EXPERIENCE, TRAINING AND SKILLS:

Strong interpersonal, written and communication skills required.

 

Excellent organizational and multi-tasking skills.

 

Must take ownership of assigned responsibilities and demonstrate ability to work independently with a positive attitude.

 

Extensive knowledge of enrollment processes preferred.

 

Demonstrate competency with Microsoft computer programs and Internet applications.

 

PHYSICAL/MENTAL REQUIREMENTS AND TYPICAL WORKING CONDITIONS:

Exposure to stressful situations, including those involving public contact, as well as, trauma, grief and death.

 

Able to wear personal protective equipment that includes latex materials or appropriate substitute if required for your position.

 

Is able to move freely about facility with or without an assisted device and must be able to perform the functions of the job as outlined in the job description.

 

Overall vision and hearing is necessary with or without assisted device(s).

 

Frequently required to sit/stand/walk for long periods of time.

 

May require frequent postural changes such as stooping, kneeling or crouching.

 

Some exposure to blood borne pathogens and other potentially infectious material. Must follow MyMichigan Health bloodborne pathogen and TB testing as required.

 

Ability to handle multiple tasks, get along with others, work independently, regular and predictable attendance and ability to stay awake.

 

Overall dexterity is required including handling, reaching, grasping, fingering and feeling. May require repetition of these movements on a regular to frequent basis.

 

Physical Demand Level: Sedentary. Must be able to occasionally (0-33% of the workday) lift or carry 0-10 lbs.

Equivalent Experience and Other Comments (Education):