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Senior Enrollment Implementation Manager

4 months ago

Bedford, United States LogixHealth Full time
Job DescriptionJob DescriptionPurpose
To provide a professional and efficient enrollment experience to new clients that are onboarding with LogixHealth. To manage a team that will assist with all tasks that associate with onboarding new clients.
Duties and Responsibilities
  • Oversee and manage staff that will work solely onboarding new clients
  • Complete and attend billing questionnaire calls and work directly with clients to ensure LogixHealth receives appropriate documentation for enrollment purposes
  • Review all documents received to make sure that the legal name matches on all documents and there are no discrepancies
  • Communicate with internal departments on progress of enrollment for all new clients and assign/complete any associated tasks within Microsoft Teams Internal New Client Billing Operations channel
    • Work with clients verifying ownership structure and then report the structure to the respective state Medicaid and Medicare
  • Identify any outliers that clients may have in their reporting structure for example, malpractice suits, sanctions and/ or reportable outliers
  • If needed, assist owners of organizations through the identity proofing process with CMS
    • Explain what this is, giving clients detailed definitions and purposes of why I&A/ PECOS platform is necessary for successful enrollment
    • This process includes setting up meetings with clients, screen sharing so that set up is successful
  • Initiate and manage all new client enrollment meetings during the implementation period
    • These meetings may be weekly/bi-weekly/ monthly dependent on the client
    • During these calls, the client will be provided a list of required items to ensure accurate enrollments
    • The LogixHealth enrollment process will be clearly communicated with education on state specific enrollment requirements provided to the client if necessary
  • A SharePoint/ One Drive excel will be created based upon received information that will be used to assist in tracking all individual provider identity required documents
  • New provider profile packets will be created specific to each client
  • Assign an audit of all providers associated with the new client to make sure their enrollments are accurate, approved and entered in the LogixHealth system accurately
  • Review/ sign off on audit before new client is released to permanent enrollment representative
  • Work directly with offshore team to ensure all assignments are on track for completion, including Symplr/ Allscripts data entry
  • Assign and manage the CAQH process for all individual providers associated with new clients
  • Submit all group level applications for new clients onboarding, including but not limited to, Medicare, Medicaid and BCBS
    • If a client resides in multiple states enrollment will need to be completed for each state
  • Submit all individual provider enrollment applications with payers as necessary
  • Manage and work with team as they identify any providers that are not enrolled/ active with applicable payers that the client is contracted with, as well as complete an out of network enrollment if necessary
  • Manage/submit all clients Medicare revalidations at the group level
  • Complete a client transfer training with a Provider Enrollment Representative once the onboarding process is complete
  • Complete/ Maintain SOP that pertains to new client processes
  • Resolve any department issues with department Associate Director/ Director/Senior Director
  • Attend regularly scheduled meetings
  • Assign work to staff and ensure completion
    • May delegate day to day oversight to supervisors or team leads
  • Ensure staff is trained and aware of job and company expectations and determine remedial action when needed
  • Ensure cooperative team environment by
    • Effectively communicating with staff about department and company initiatives
    • Adjusting procedures as necessary to create process efficiencies
    • Resolving issues among staff
    • Encouraging constructive feedback from staff and between team members
  • Manage recruitment process including
    • Identifying needs
    • Posting internally
    • Screening and interviewing candidates
  • Comply with all State and Federal Laws regarding an effective Compliance Program inclusive of HIPAA Privacy and Security
    • Adhere to the Code of Conduct and be familiar with all compliance policies and procedures stored in LogixGarden relevant to this position
    • Ensure departmental employees follow the Code of Conduct, compliance policies and procedures
    • Administer the appropriate sanction when an employee violates a compliance policy or procedure
  • Review and approve time and attendance records according to company standards
  • Provide on-going feedback and annual performance reviews
  • Uphold company mission, vision and values
  • Proactively monitor company policies and address transgressions appropriately
  • Facilitate meetings within department and make presentations to senior management as needed
  • Monitor and enforce compliance with all pertinent local, state, and federal laws and regulations relating to operations and employment
Qualifications
To perform this job successfully, an individual must be able to perform each duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities perform the duties.
Education (Degrees, Certificates, Licenses, Etc.)
Bachelor’s degree or equivalent combination of education and experience required.
Computer Skills
Prior word processing, spreadsheet and internet software experience including proficiency with MS Excel and MS Word required.
Experience
2 - 4 years of related experience in a healthcare setting preferred.
Specific Job Knowledge, Skill and Ability
  • Ability to handle client and provider information discreetly and confidentially
  • Ability to organize information with a strong attention to detail
  • Ability to build and maintain strong client/provider relationships
  • Ability to comprehend and communicate contract information
  • Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedural manuals
  • Ability to write routine reports and correspondence
  • Ability to communicate effectively verbally and in writing
  • Ability to apply common sense understanding to carry out instructions
  • Specific vision abilities required by this job include close vision
  • Ability to sit for prolonged periods of time, use hands, talk, hear and occasionally walk and reach with hands or arms

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