Credentialing and managed care enrollment coordinator

Medical University of South Carolina • Charleston, SC

4d

About The Position

Ensures that appropriate medical staff privileges are received and billing enrollment process is completed for all new providers and locations. 25%
Manages the credentialing and enrollment process with all governmental and commercial payors in a timely fashion on behalf of all MCP providers. 25%
Acts as liaison to assist in resolving contract implementation and payment issues with all contracted carriers. 25%
Acts as liaison for patient accounting with managed care payors for all provider enrollment-related claims issues and takes appropriate action to implement solutions to enrollment-related claims issues. Ensure providers are appropriately categorized for payment purposes with all payors. This process will include completing new provider applications, ensuring that provider credentialing is received and processed timely by the medical staff office, and making credentialing decisions and effective dates. 25%
Additional Job Description Bachelors Degree or equivalent Work Experience: 4-6 of related work experience in medical staff office operations, revenue cycle, and provider enrollment. Very organized, has high attention to detail, and is able to work independently. Strong analytical and problem-solving skills. Strong interpersonal and communication skills (written/verbal). Knowledge of Excel, Word, and Outlook. Familiarity with database programs. If you like working with energetic enthusiastic individuals, you will enjoy your career with us! The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need. Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: http://www.uscis.gov/e-verify/employees Thank you for wanting to be part of the Medical University of South Carolina team. Whether you want to teach the next generation of health care leaders, innovate new business models, discover the next breakthrough or provide patient care, there's a role for you that fuels your passion and takes advantage of your skills. There are career opportunities available in academics, research, hospital medicine, physician practices and support services, from patient billing to IT. As an applicant, you can search jobs for all MUSC entities as well as search by category and location. MUSC attracts more than $250 million annually in research funding, making it the biggest magnet for biomedical, extramural research dollars of all institutions of higher learning in South Carolina. The Clinical and Translational Science Award (CTSA) Program aims to advance clinical and translational science to increase the speed at which new treatments become available to patients. MUSC Health, the clinical enterprise, operates a 750 bed medical center, which includes a nationally recognized Children’s Hospital, the Ashley River Tower (cardiovascular, digestive disease, and surgical oncology), Hollings Cancer Center (one of fewer than 70 elite National Cancer Institute designated centers), a Level I Trauma Center and the Institute of Psychiatry. In addition, there are more than 100 outreach clinics, hospital/health system affiliations, and telehealth sites. U.S. News & World Report placed us among the top one percent of all American hospitals, with 11 specialties in the top 50. The MUSC Medical Center is also one of only three Magnet® designated hospitals in South Carolina.

Requirements

• Bachelors Degree or equivalent Work Experience: 4-6 of related work experience in medical staff office operations, revenue cycle, and provider enrollment.
• Very organized, has high attention to detail, and is able to work independently.
• Strong analytical and problem-solving skills.
• Strong interpersonal and communication skills (written/verbal).
• Knowledge of Excel, Word, and Outlook.
• Familiarity with database programs.

Responsibilities

• Ensures that appropriate medical staff privileges are received and billing enrollment process is completed for all new providers and locations.
• Manages the credentialing and enrollment process with all governmental and commercial payors in a timely fashion on behalf of all MCP providers.
• Acts as liaison to assist in resolving contract implementation and payment issues with all contracted carriers.
• Acts as liaison for patient accounting with managed care payors for all provider enrollment-related claims issues and takes appropriate action to implement solutions to enrollment-related claims issues.
• Ensure providers are appropriately categorized for payment purposes with all payors.
• This process will include completing new provider applications, ensuring that provider credentialing is received and processed timely by the medical staff office, and making credentialing decisions and effective dates.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level