Senior Provider Enrollment Coordinator

University of Arkansas System•Little Rock, AR

7d•Hybrid

About The Position

The University of Arkansas for Medical Sciences (UAMS) has a unique combination of education, research, and clinical programs that encourages and supports teamwork and diversity. We champion being a collaborative health care organization, focused on improving patient care and the lives of Arkansans. This position will be responsible for the technical processes and requirements of the provider enrollment workflows, including group/clinic EDI/ERA/EFT enrollments, reporting, managing Epic WQs, and interfacing with the Epic IT teams to ensure providers are enrolled & linked correctly in accordance with revenue cycle build requirements. The Senior Provider Enrollment Coordinator will provide project management support related to the oversight of provider enrollment work processes, including creation/implementation of policies, processes & workflows to ensure providers are enrolled with payers accurately & timely; must be able to manage & prioritize multiple tasks/priorities that support the provider enrollment processes; and will work closely with the Epic IT team, revenue cycle team, and credentialing/PSO teams at UAMS, ACH & ACNW, as well as external vendors/payors. Remote requirements include 90 days on site training; up to 2 days per week on-site thereafter.

Requirements

Bachelor’s degree plus two (2) years of experience in healthcare or healthcare management, including experience in payer revenue cycle, billing, claims, and/or Electronic Data Interchange (EDI), or
Associate's degree plus four (4) years of experience in healthcare or healthcare management, including experience in payer revenue cycle, billing, claims, and/or EDI, or
High School diploma/GED plus six (6) years of experience in healthcare or healthcare management, including experience in payer revenue cycle, billing, claims, and/or EDI required.
Must have strong problem-solving and communication skills.
Meticulous accuracy required to support data integrity and analysis.
Proof of legal authority to work in the United States on the first day of employment.

Responsibilities

Maintain/support electronic enrollments for EDI.
Completion of payor and/or clearinghouse enrollment forms (many via online portals) to ensure UAMS providers and/or groups/clinics are enrolled/connected accurately & timely.
Work closely with Epic IT, Payment Posting, and other Rev Cycle teams to ensure enrollments are accurate and interface appropriately with other electronic processes. This may involve researching RA/EOBs and/or reaching out to payors/sources to obtain information that assists in analysis.
Responsible for ensuring Epic WQs are reviewed/worked timely.
Works accounts to resolution in a manner that sets a standard for other employees. Utilizes numerous systems, EPIC, Echo Credentialing System, Insurance Websites, EPF, FGP Billing Website, Out-of-State Medicaid database, and ON DEMAND FORMS to obtain information to resolve issues
Maintains workload of the exceptionally complex enrollments and/or enrollment-related account issues - which may include billing group enrollment/maintenance, high volume payor enrollments/relationships, complex account issues related to enrollment referred by other employees for resolution.
Maintains working knowledge of third-party payer rules and regulations and applies this in resolving problem charges.
Shares knowledge acquired through account follow-up with Unit Manager and staff.
Provide guidance & support for the department’s workflow and daily operations, including problem solving/resolution in Provider Enrollment.
Assist in establishing, reviewing & implementing procedures and timelines.
Provide projections, specialized research, historical information, and related information, and review and update all operating procedures as needed to ensure maximum efficiency within the office.
Work with Professional Staff Offices at University Hospital and Arkansas Children’s Hospitals to share information and to develop procedures and processes to ensure a smooth and productive flow of information between the offices and to improve the overall services provided.
Work with physicians, other professional health care providers, insurance companies, COM departments, Credentialing, UAMS Professional Billing Office, and others to ensure that all provider enrollment is completed in an accurate and timely manner.
Oversee the operational processes (initial enrollment, recertification/revalidation & expirables management) required to ensure that UAMS health care providers can bill and collect for professional services.
Develop & prepare various reports to track Enrollment processes and automate the processes where possible.
Develop reporting tools, manage all related status reports, and will manage all renewals and updates for Enrollment. The position will perform other management, research, computing, and analysis work supporting Enrollment.
Perform other duties as needed or as requested.