Enrollment Coordination Specialist

2 weeks ago

Washington, United States Howard University Full time

The Talent Acquisition department is dedicated to recruiting qualified individuals who contribute to the strategic success of Howard University. Our focus on hiring staff that align with our values significantly enhances our mission.

At Howard University, we emphasize the importance of well-being and professional development.

Here is what we provide:

  • Health & Wellness: Comprehensive medical, dental, and vision insurance, along with mental health support.
  • Work-Life Balance: Paid time off, holidays, and flexible work arrangements.
  • Financial Wellness: Competitive salary and a 403(b) plan with company matching.
  • Professional Development: Continuous training, tuition reimbursement, and pathways for career advancement.
  • Additional Perks: Wellness initiatives, commuter benefits, and a vibrant organizational culture.
BASIC FUNCTION:

This role serves as the intermediary between the Faculty Practice Plan, the physician group, the hospital, and various insurance providers. The incumbent operates with a high degree of autonomy, receiving general guidance from department supervisors or directors.

SUPERVISORY ACCOUNTABILITY:

Responsible for managing and overseeing the payer enrollment process, ensuring its effectiveness and compliance with relevant accreditation and regulatory standards. This encompasses initial enrollment, re-enrollment, and management of expirables. The role requires maintaining current knowledge of pertinent statutes and laws related to credentialing while ensuring adherence to applicable regulations.

NATURE AND SCOPE:

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

PRINCIPAL ACCOUNTABILITIES:
  • Coordinates the enrollment and credentialing processes as dictated by the stringent guidelines for third-party payer physician enrollment, in accordance with NCQA and other regulatory standards.
  • Oversees the payer revalidation process, particularly for Medicare and Medicaid, collaborating closely with the Provider Enrollment Relations Manager to ensure smooth coordination of activities.
  • Generates monthly audit reports for Medicare sanctions and opt-out cases.
  • Maintains effective communication between the physician group and various third-party payers through exceptional verbal and written skills.
  • Facilitates the distribution and understanding of information from third-party payers related to insurance billing.
  • Updates and disseminates the monthly roster for all third-party payers, ensuring all relevant data fields are populated for new physicians and terminations.
  • Coordinates and directs 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.
  • Acts as the liaison between physicians, facilities, and third-party payers.
  • Monitors the re-enrollment and expirable processes for all medical staff, ensuring compliance with regulatory bodies and organizational policies.
  • Addresses inquiries from healthcare organizations and collaborates with internal and external stakeholders to resolve enrollment and credentialing issues promptly.
  • Identifies issues requiring further investigation, verifies discrepancies, and ensures thorough follow-up procedures are executed.
  • Enhances operational efficiency by executing query, report, and document generation tasks.
  • Participates in special projects as necessary to maintain files and records.
CORE COMPETENCIES:
  • Advanced knowledge of accreditation and certification requirements.
  • Proficient in using databases, including crafting queries and generating reports.
  • Intermediate proficiency in personal computers and Microsoft Office applications.
  • Ability to utilize critical thinking skills for problem-solving and procedural decision-making.
  • Strong communication skills, both verbal and written, with the ability to engage effectively with diverse audiences.
  • Demonstrates the ability to foster positive and collaborative relationships with faculty, staff, students, and the public.
MINIMUM REQUIREMENTS:

Bachelor's Degree in a related field with 1-3 years of general work experience, or 8 years of relevant experience in lieu of educational qualifications.

Compliance Salary Range Disclosure:

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

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