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Enrollment Services Coordinator

2 months ago

Washington, United States Howard University Full time

The Talent Acquisition department is dedicated to selecting qualified individuals who will contribute to the strategic success of Howard University. Our hiring philosophy emphasizes finding candidates who align with our mission and values.

At Howard University, we prioritize employee well-being and support professional development.

Here’s what we provide:

  • Health & Wellness: Comprehensive medical, dental, and vision coverage, along with mental health resources.
  • Work-Life Balance: Paid time off, holidays, and flexible work options.
  • Financial Wellness: Competitive salary and a 403(b) retirement plan with company contributions.
  • Professional Development: Continuous training, tuition assistance, and pathways for career advancement.
  • Additional Perks: Wellness initiatives, commuting benefits, and a vibrant workplace culture.
BASIC FUNCTION:

This role serves as the intermediary between the Faculty Practice Plan, the physician group, the hospital, and various insurance providers. Employees in this position operate with a high degree of autonomy, guided by general supervision from departmental leadership.

SUPERVISORY ACCOUNTABILITY:

The incumbent is responsible for overseeing and managing the payer enrollment process, ensuring compliance with relevant accreditation and regulatory standards. This includes initial enrollments, re-enrollments, and management of expirables. The role requires maintaining current knowledge of pertinent statutes and laws related to credentialing, ensuring adherence to applicable regulations.

NATURE AND SCOPE:

Internal contacts may include senior administrators, faculty, and staff. External contacts may involve payers, vendors, consultants, and the general public.

PRINCIPAL ACCOUNTABILITIES:
  • Oversees the enrollment and credentialing processes as dictated by rigorous third-party payer guidelines, adhering to NCQA and other regulatory standards.
  • Manages the payer revalidation process, particularly focusing on Medicare and Medicaid, collaborating closely with the Provider Enrollment Relations Manager to ensure smooth operations.
  • Generates monthly audit reports for Medicare sanctions and opt-out cases.
  • Maintains effective communication between the physician group and various third-party payers through excellent verbal and written skills.
  • Facilitates clear communication between the physician group and multiple third-party payers, ensuring understanding through exceptional communication abilities.
  • Coordinates audits and site reviews conducted by third-party payer representatives.
  • Organizes training sessions for operational staff with various third-party payers.
  • Ensures the dissemination and understanding of information from third-party payers related to insurance billing processes.
  • Updates and distributes the monthly roster for all third-party payers, ensuring accuracy for new physicians and terminations.
  • Coordinates the onboarding process for new providers.
  • Maintains a comprehensive physician database and updates relevant applications, monitoring practitioner status for accuracy.
  • Manages databases and practice management systems utilized by the organization.
  • Maintains a reference library of third-party payer manuals and directories.
  • Acts as the liaison between physicians, facilities, and third-party payers.
  • Monitors the re-enrollment and appointment processes for all medical staff, ensuring compliance with regulatory bodies and internal policies.
  • Addresses inquiries from healthcare organizations and collaborates with stakeholders to resolve enrollment and credentialing issues promptly.
  • Identifies issues requiring further investigation, verifies discrepancies, and ensures thorough follow-up.
  • Enhances operational efficiency by executing queries, generating reports, and submitting database reports in compliance with healthcare regulations.
  • Participates in special projects as needed to maintain records and files.
CORE COMPETENCIES:
  • In-depth knowledge of accreditation and certification requirements.
  • Proficient in database management, including query crafting and report generation.
  • Intermediate proficiency in personal computers and Microsoft Office applications.
  • Skilled in utilizing provider dictionaries such as NCQA, NPPES, and CAQH.
  • Ability to apply critical thinking to problem-solving and procedural decision-making.
  • Ability to maintain confidentiality and exercise discretion.
  • Effective verbal and written communication skills with diverse audiences.
  • Proven ability to foster positive working relationships with faculty, staff, students, and the public.
MINIMUM REQUIREMENTS:

A Bachelor's Degree in a related field and 1-3 years of relevant work experience. Alternatively, 8 years of related experience may substitute for educational qualifications.

Compliance Salary Range Disclosure

Expected Pay Range: $50,882 - $55,971