Job Information
LogixHealth Provider Enrollment Manager in Bedford, Massachusetts
Location: Bedford, MA; Remote in AL, FL, GA, MI, MO, NC, NH, OH, OK, TN, TX, WI, AND WV
Purpose
The Manager, Provider Enrollment is responsible for assigned functions and oversight of daily operations. The Manager, Provider Enrollment oversees process, work and performance of team members (stateside and international). This position provides leadership and support for the Provider Enrollment team managing all aspects of employee engagement, performance, quality, and ensures accountability and equitable distribution of work. The Manager is a member of the Provider Enrollment Leadership team and is responsible for workflow development, action planning, and other departmental initiatives.
Duties and Responsibilities
Team Leadership: supervise and provide guidance, coaching, and performance management to provider enrollment teammates
Enrollment Process Management: Organize, oversee and manage all aspects of provider enrollment processes
Relationship Management: Build and maintain effective relationships with internal and external stakeholders
Meeting Management
Vendor Management-Identify opportunities to leverage vendors, ensure training, auditing, and management of vendor performance
Compliance: Maintain strict adherence to organization and department policies and stay abreast of payer regulations, enrollment requirements, and industry best practices
Process Improvement: Identify opportunities for process improvement and efficiency enhancements
Reporting and Analytics: utilize reports, dashboards, and other data sources to analyze enrollment data to track performance metrics and proactively identify trends
Critical Thinking and Communication: Identify and concisely communicate any matters that may lead to enrollment and/or cash flow delays or losses
Department Support: Lead, participate, and engage in department initiatives, that may be outside of the scope of day-to-day responsibilities
Comply with all State and Federal Laws regarding an effective Compliance Program inclusive of HIPAA Privacy and Security
Adhere to the Code of Conduct and be familiar with all compliance policies and procedures stored in Company intranet relevant to this position
Ensure departmental employees follow the Code of Conduct, compliance policies and procedures
Administer the appropriate sanction when an employee violates a compliance policy or procedure
Qualifications
To perform this job successfully, an individual must be able to perform each duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities perform the duties.
Education (Degrees, Certificates, Licenses, Etc.)
Bachelor’s degree preferred.
Computer Skills
Familiar with Office 365 at an intermediate or above level.
Experience
5+ years of related experience
3+ years management experience in critical thinking, problem solving and research
2+ years experience in personnel management with diverse and remote teams required
Group enrollment, multi-specialty and multi-state provider enrollment experience preferred
Proficiency with enrollment software and payer portal databases (PECOS, CAQH, NPPES)
Provider enrollment specialist certificate (PESC) preferred
Specific Job Knowledge, Skill and Ability
Intermediate knowledge of provider enrollment processes and requirements for federal, state, and commercial payers
Ability to concisely summarize issues, create timelines, and prepare scenarios of escalation to leadership, payers, legal, etc.
Ability to manage issues to resolution
Knowledge of revenue cycle processes
Possesses advanced presentation skills
Demonstrates critical thinking
Possesses project management skills
Ability to work both autonomously and as part of a team
Possesses conflict resolution skills
Excellent customer service, written and verbal communication skills
Ability to communicate effectively verbally and in writing
Ability to apply common sense understanding to carry out instructions
Specific vision abilities required by this job include close vision
Ability to sit for prolonged periods of time, use hands, talk, hear and occasionally walk and reach with hands or arm
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