Government Program Enrollment Coordinator

6 days ago

Baltimore, Maryland, United States University of Maryland Medical System Full time
Job Description

At the University of Maryland Medical System, we are seeking a skilled Government Program Enrollment Coordinator to join our team. As a key member of our enrollment operations team, you will be responsible for managing the enrollment of participating providers in government systems, including initial applications and revalidations.

Key Responsibilities:

  • Manage health system level services for enrollment of employed providers, facilities, and other entities within UMMS with governmental payers for claims submission.
  • Collect, monitor, and analyze enrollment operations performance data relative to established goals and metrics to identify potential risks and areas of opportunity.
  • Participate in acquisition/integration teams and oversee enrollment-related responsibilities of onboarding new individual providers, provider groups, or service line/facilities.
  • Collaborate with and serve as primary point of contact for all UMMS enrollment stakeholders, including senior leaders, payer contracting, compliance, legal, central billing office, independent providers/administration staff, and hospital medical staff offices.
  • Ensure quality control content and completeness of provider data within the enrollment software system.
  • Develop and implement effective training programs, policies, and processes to ensure best practice adoption.
  • Implement and maintain a shared file for enrollments.
  • Develop, maintain, update, and oversee policy and procedures of the enrollment function, including policy and procedure manuals and enrollment procedures with 3rd party payers and internal partners.
  • Track progress and implement quality improvement of enrollment operations to ensure optimal revenue capture.
  • Develop goals to reduce enrollment processing time in areas UMMS can directly control.
  • Develop a best practices system for enrollment and continuously streamline processes to track work output.
  • Oversee quarterly reconciliation of provider lists and binding authority documentation to ensure adequate enrollment procedures for payers.

Qualifications:

  • Bachelor's degree in Finance, Business, IT, Healthcare Administration, or a related discipline.
  • Five years of experience, including 1-2 years hands-on experience in payor enrollment, provider enrollment, contracting, or credentialing, and 2-3 years of experience in claims processing, provider billing, revenue cycle, or related work.
  • Government payer experience is preferred.
  • Multi-specialty experience is ideal.

Knowledge, Skills, and Abilities:

  • Demonstrated ability to work with professional, multi-disciplinary teams as a group leader and participant.
  • Demonstrated expertise in healthcare payer contracting, enrollment, and/or billing.
  • Knowledge of healthcare and managed care delivery systems.
  • Proficiency in standard computer applications, including MS Office suite applications.
  • Ability to work effectively and improvise when approached with immediate deadlines and unprompted changes to project plans.
  • Demonstrated ability to think strategically and generate innovative and practical solutions to complex or unusual problems.
  • Highly effective verbal and written communication skills to work with all levels within the organization and produce clear and concise reports of relatively complicated issues.

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