Minimum Qualifications:
Bachelor’s degree or equivalent in related field and six years’ experience with provider enrollment, hospital and physician billing or health plan experience.
Job Summary:
To oversee the provider enrollment function with all government and commercial payors and maintain enrollment status of providers.
Preferred Qualifications:
Experience with LEAN or other process improvement initiatives; systems implementation.
Two or more years of management experience.
Proficient in MS Outlook, Word, Excel, and PowerPoint
Job Duties:
Oversees all UTMB activities related to provider enrollment with government and commercial payors.
Establishes and maintains regular reports and communications regarding provider enrollment initiatives and network participation status to departments within the School of Medicine and other stakeholders.
Develop protocols and implement process improvement initiatives to ensure timely enrollment of new providers to ensure proper billing and collections for all new providers.
Maintains integrity of provider data in the provider database and ensures compliance with all rules and regulations regarding the enrollment and status of providers.
Provides feedback to upper management regarding section activities through written reports, correspondence, and verbal communication.
Manage and resolve provider enrollment issues resulting in billing disputes.
Maintains current electronic forms, processes, and policies/procedures to be in compliance with accrediting and regulatory bodies.
Design and conduct training regarding provider enrollment process and systems/process improvement initiatives.
Provide guidance and assistance to providers on completing all required information/registrations for enrollment with Medicare, Medicaid, and other payors.
Monitor, track, and prepare reports on the enrollment status of providers, and respond to audit and compliance requests as needed.
Collaborate with the Medical Staff Office on regular and ad hoc delegation reports/audits.
Manage and develop direct reports.
Performs related duties as required.
Preferred Qualifications:
Experience with LEAN or other process improvement initiatives; systems implementation
2 or more years of management experience
Proficient in MS Outlook, Word, Excel, and PowerPoint
Relevant UTMB experience.
Salary Range:
Commensurate with experience.
Work Schedule:
Monday through Friday, 8am to 5pm and as needed on occasion.
EQUAL EMPLOYMENT OPPORTUNITY:
UTMB Health strives to provide equal opportunity employment without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, genetic information, disability, veteran status, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law.
As a VEVRAA Federal Contractor, UTMB Health takes affirmative action to hire and advance women, minorities, protected veterans and individuals with disabilities.
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