Supervisor, Provider Enrollment

Med-Metrix•Red Bank, NJ

About The Position

The Supervisor, Provider Enrollment is responsible for the supervision and oversight of global staff and policies & procedures, and working closely with the Manager, Provider Enrollment to ensure the credentialing/enrolling of new and established health care providers and other policies/procedures of the department are being followed.

Requirements

High school diploma or equivalent required
Minimum 5 years’ experience in Provider Enrollment required
Knowledge of and experience in healthcare billing preferred
Experience with CAQH required
Microsoft Office Suite knowledge/use required
Strong interpersonal skills, ability to communicate well at all levels of the organization
Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses
High level of integrity and dependability with a strong sense of urgency and results oriented
Excellent written and verbal communication skills required
Gracious and welcoming personality for customer service interaction
Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes.

Responsibilities

Oversee issue resolution for the provider education process regarding application completion and submission
Oversee and ensure that the collection, updating and maintenance of necessary provider information and documentation is completed
Oversee and ensure that the enrollment follow-up, by client and payer, is completed within departmental and client parameters
Ensure that provider enrollment applications for all initial applications and re-credentialing are completed in a timely and complete manner
Ensure verification of provider and group information with insurance companies is completed
Ensure that the information for enrollment and termination of all providers is accurate and communicate to team and clients as appropriate.
Implement and maintain client and Company Q/A standards and protocols and coordinate with department manager quarterly reporting of same
Act as the point of contact to the client to troubleshoot any issues and escalate as needed to management
Contribute to the departmental process and procedures with a collaborative approach
Monitor mPower and other provider reports to ensure they are kept current and report any deficiencies in same
Assist in the training and education on enrollment processes or required research for accuracy, ensuring that all training activities are complete and up to date
Document and record training sessions to be used for future reference
Monitor and analyze productivity along with performing Q/A for all staff
Provide timely feedback to offshore provider enrollment regarding Q/A process and results
Identify struggles with Provider Enrollment staff and provide guidance when needed globally
Performs other duties as requested
Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
Understand and comply with Information Security and HIPAA policies and procedures at all times
Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties