PURPOSE AND SCOPE:

This position is responsible for:

State Medicaid application process

Medicare EDI enrollment.  

ERA, EFT, Claims Enrollment

DDE and payer website access

Applications for specific non-network payors

Functions as a centralized group to best serve the Business for all enrollment needs. Provide visibility to the organization on the status of facilities during the enrollment processes. Cultivate and maintain a professional relationship with industry partners.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

Follow Acquisition, Joint Venture and DeNovo facility from rumor to completion (point of billing)

Participate in the acquisition, JV conversion and new facility calls

Assists Regulatory with CMS 855 application issues & follow up

Track completion of state license and CLIA

Monitor for expiration of state licenses and provide current documents to State Medicaid

EDI Enrollment with Medicare Administrative Contractor (MAC)

Facility setup for Electronic Claims in Relay Health

Establish connection with Corporate DSD EDI

Add PTAN's to MDE transmission via Relay Health

Complete Medicaid applications to include all required facility documents and managing employee Medicaid Disclosure Questionnaire's (MDQ). Work with internal Regulatory and Legal teams to ensure all disclosure information is current and accurate

Document management - KIMA/ExtraView and the EDS Team SharePoint site

Medicaid Re-credentialing

Medicare PTAN, Medicaid provider #, and location addresses updates in Facility Database

Facility relocation reporting to state Medicaid programs

Revenue Center assignment in Big Wave system

Medicare DDE enrollment and recertifications

Establish/terminate Revenue Centers and Cash Departments access to all insurance payer websites

Commercial payer enrollment for EFT, ERA and electronic claims

Reenroll commercial payors for ERA, EFT, Claims

Tricare applications for non-network participation

Blue Cross Blue Shield applications for out of network provider numbers.

Create and maintain all W9's

Other duties as assigned

Additional responsibilities may include focus on one or more departments or locations. See applicable addendum for department or location specific functions.

PHYSICAL DEMANDS AND WORKING CONDITIONS:

The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION:

High School Diploma

EXPERIENCE AND REQUIRED SKILLS:

Minimum 1 year experience in medical accounts receivable

Strong time management skills and the ability to juggle multiple tasks

High level of creativity, innovation, initiative, and sense of ownership

Organizational capabilities and strong attention to detail

Self-motivated, quick learner and independent thinker

Must be able to work well independently, and in a team environment

Must be capable of quickly identifying issues and provide recommendations

Excellent verbal/written and communication skills

Proficient in MS Excel

Protect highly sensitive and confidential information

EO/AA Employer: Minorities/Females/Veterans/Disability/Sexual Orientation/Gender Identity

Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.

EO/AA Employer: Minorities/Females/Veterans/Disability/Sexual Orientation/Gender Identity

Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.