Government Program Enrollment Coordinator
3 weeks ago
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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