Enrollment Specialist

Details

Posted: 24-May-24

Type: Full-time

Salary: Open

Categories:

Administrative/Support
Staff/Administrative

Internal Number: R104952

Position Summary
The Delegated Enrollment Specialist will be responsible for all activities related to enrollment of providers for government payors and assuring continued enrollment. Supporting the maintenance of provider demographics (practicing addresses, billing addresses, NPI, Medicare / Medicaid numbers) to support delegated credentialing with payers and the accountable care organization (ACO). The primary responsibility will be initiating and monitoring the provider corporate credentialing functions to assure that all practitioners and all clinical billing organizations are enrolled in all required and government payor programs in accordance with established thresholds (Medicare, Medicaid, Bureau of Workers Compensation, etc.) and enrollment into other both delegated and non-delegated health plans. Enrollment specialists may also be asked to work on special projects required for ongoing business relationships and strategic initiatives. Position requires excellent written and verbal communication skills and the ability to work independently, while managing multiple priorities to ensure proper claims payment and no loss of revenue.

Minimum Qualifications
Education and Experience:
Bachelors degree (preferably in healthcare field) and two years experience in a hospital setting and/or managed care setting with demonstrated experience in enrollment functions, or equivalent combination of education and experience
Skills and Demeanor:
Strong verbal and written communication skills are critical to position; ability to understand government payor issues and resolve problems with Medicare/Medicaid executives
Strong organizational skills, attention to detail and ability to prioritize workload
Ability to communicate effectively with all levels of management, clinical departments and physicians
Ability to work with minimal supervision and to maintain confidentiality due to access to sensitive information
Ability to problem solve and think creatively
Knowledge of CMS guidelines for enrollment
Working knowledge of Microsoft Word, Excel, Adobe Acrobat Pro

Maintains a positive demeanor, actively participates in team/department meetings and assists the department in identifying areas of opportunity
Ongoing Requirements:
Demonstrates excellent interpersonal, cognitive, written, and trouble-shooting skills. Demonstrates professionalism, accuracy, and proficiency in completing position responsibilities. Remains current on Federal and State requirements relating to managed care and physician credentialing.

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About The Ohio State University
The Ohio State University is a dynamic community of diverse resources, where opportunity thrives and where individuals transform themselves and the world. Founded in 1870, Ohio State is a world-class public research university and the leading comprehensive teaching and research institution in the state of Ohio. With more than 63,000 students (including 57,000 in Columbus), the Wexner Medical Center, 14 colleges, 80 centers and 175 majors, the university offers its students tremendous breadth and depth of opportunity in the liberal arts, the sciences and the professions.
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