Remote work eligible position
Responsible for performance of provider enrollment functions for assigned market, which includes, but is not limited to completing CMS-855A, CMS-855B, CMS-855S, CMS-855R, and MDPP Medicare enrollment applications, Medicaid enrollments applications, commercial enrollment applications, and assisting with the claims denials and operational write offs related to the enrollment of entities, locations or individuals within the market.
ESSENTIAL FUNCTIONSKnows, understands, incorporates, and demonstrates the Trinity Health mission, vision and values in behaviors, practices, and decisions.
Completes and maintains the following Provider applications (both Initial and Re-credentialing/Renewals) as required (completion of applications also includes conducting any necessary follow-up to ensure timely completion of process): Payer Enrollment/Credentialing DEA/ Licensure Revalidations CAQH MSOW
Updates and maintains provider demographic information in credentialing database.
Requests and maintains updated credentialing documents from providers on an ongoing/as needed basis and prior to any expirations to ensure there is no lapse in coverage or provider status.
Runs regularly scheduled reports to address any outstanding applications, issues, and expiring information.
Provides status updates on all credentialing requests to Supervisor or other key stakeholders.
Completes and maintains Facility applications: Completes Medicare, Medicaid, and commercial enrollment applications, as required by CMS/MAC, state administrators and commercial payors. Ensures all Medicare enrollment information is sent to System Office Provider Enrollment for System Office central filing, in addition to local filing.
Attends team meetings, phone conferences, and training as needed; facilitate team meetings and phone conferences as needed.
Attends quarterly onsite team meetings as needed.
Participates in department projects as requested.
Other duties as needed and assigned.
Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health’s Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.
Hourly pay range: $21.0971 - $31.6457
MINIMUM QUALIFICATIONSMust have an understanding of government and commercial payor provider and facility enrollment functions in addition to an understanding of how provider enrollment interacts with other functional areas within the revenue cycle, including finance, PFS and reimbursement. Must also understand and be able to coordinate with other departments which are responsible for maintenance of documentation and decisions needed for provider enrollment work such as finance, legal, MGPS and clinical credentialing. Bachelor’s degree in Business Administration or Healthcare Administration, as well as one (1) to three (3) years of experience within revenue cycle related departments, or an equivalent combination of education and experience required. Experience in a multi-entity company with provider enrollment functions is strongly preferred.
Ability to manage multiple, concurrently running projects, prioritize tasks and adapt to frequent changes in departmental priorities. Ability to recognize necessary changes in priority of tasks and bring them to the attention of the functional area manager.
Strong organization, analytical and quantitative skills.
Strong written and verbal communication skills.
Some familiarity with healthcare finance and revenue cycle terminology and concepts.
Ability to develop appropriate methodologies for collecting, analyzing, and evaluating data.
Ability multi- task and to work independently with minimal supervision of daily tasks.
Ability to work with sensitive, confidential information.
Ability to work with non-provider enrollment colleagues and provide/explain requirements and processes for government provider enrollment.
Strong personal computer skills, especially with Microsoft applications and EPIC.
Understanding of legal requirements related to maintenance and storage of Personal Identifiable Information (PII) required for provider enrollment applications.
Must be comfortable in a collaborative, shared leadership environment.
A personal presence which is characterized by a sense of honesty, integrity and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Trinity Health.
PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONS
1.This position operates in an office and/or remote environment. The area is well-lit, temperature controlled and free from hazards and barriers. Manual dexterity is needed to operate a computer keyboard and copy machine. This is a fast-paced department in which concentration is required. There are frequent interruptions and numerous deadlines. The position communicates frequently in person and over the phone and therefore, verbal and hearing skills are needed for extensive telephone and in person communication. Completion of work requires some lifting, reaching, and kneeling, usually involving binders, files, and small boxes. Overtime will be required at certain times to meet deadlines.
2.Must be able to adapt to frequently changing work priorities.
3.Must be able to travel to the various Trinity Health sites. Travel is under 10%.
The above statements are intended to describe the general nature and level of work being performed by persons assigned to this classification. They are not to be construed as an exhaustive list of duties so assigned.
Our Commitment to Diversity and Inclusion
Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.