Team Lead, Provider Enrollment

Med-Metrix•Red Bank, NJ

About The Position

The Team Lead, Provider Enrollment is responsible for training and oversight of offshore team members and assisting the provider enrollment manager 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 graduate or equivalent required
4 years of provider enrollment experience
Knowledge of Microsoft Word, Outlook, Excel, CAQH
Strong organizational skills and the ability to prioritize work
Excellent written, verbal and interpersonal skills
Proficiency in Microsoft Office Suite
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.

Nice To Haves

Billing knowledge and experience preferred

Responsibilities

Assist in the oversight of issue resolution for the provider education process regarding application completion and submission
Assist in the oversight of ensuring that the collection, updating and maintenance of necessary provider information and documentation is completed
Assist in ensuring 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
Assist in the oversight to ensure that verification of provider and group information with insurance companies is completed
Assist in the coordination of information for enrollment and termination of all providers and communicate to team and clients as appropriate
Contributes to the departmental process and procedures with a collaborative approach
Assist in the oversight of the monitoring of provider enrollment work queues and smart feeds and other provider reports to ensure they are kept current and communicate areas of opportunities and trends to the Manager
Assist in the training and education on enrollment processes or required research for accuracy
Organizes, schedules and conducts all training activities of the onshore and offshore provider enrollment team as it relates to enrollment follow-up
Documents and records training sessions to be used for future reference
Monitors and analyzes productivity along with performing Q/A for offshore team
Provides timely feedback to offshore provider enrollment regarding Q/A process and results
Identify struggles with offshore provider enrollment staff and provide guidance when needed
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