25 days old

901276 Enroll Maintenance Coor

Penn Medicine
Philadelphia, PA 19104
Job SummaryThe Enrollment Maintenance Coordinator will be part of a team responsible for the enrollment of Penn Medicine billable (employed/contracted) practitioners with contracted health plans to ensure Penn Medicine's ability to bill and receive reimbursement for services rendered to patients. Includes understanding and complying with the enrollment processes of assigned health plans, researching and resolving enrollment related issues, and communicating with internal and external clients. The Enrollment Maintenance Coordinator will be responsible for initiating the enrollment process and tracking it to completion with assigned health plan(s).Accountabilities¢\tWorks with providers, departments, and Professional Billing Office staff to complete provider enrollment process in a timely and efficient manner in accordance with service standards.¢\tWorks with health plan staff to ensure their information needs are met and that they provide provider numbers on a timely basis¢\tCompletes, submits and follows up on managed care exports and/or indemnity applications sent to the assigned health plans for enrollment into their network ¢\tEnsures that provider and practice changes are submitted to the assigned health plans and are accurately processed by the health plans¢\tPerforms special projects and/or runs reports to support the provider enrollment process for the assigned health plans¢\tMaintains proficiency in utilization of enrollment databases and other systems required for enrollment with assigned health plans (e.g. PECOS, Promise)¢\tServes as liaison between the departments/practices and health plans in order to resolve enrollment issues¢\tAnalyzes the various Enrollment Reports for assigned plans to ensure that the providers enrollments have been completed with the health plans ¢\tResearches department/practice complaints and/or independently identifies data errors/inconsistencies and other problem areas with enrollment database and resolves or refers issues to manager as appropriate¢\tPerforms duties in accordance with Penn Medicine and entity values, policies, and procedures¢\tOther duties as assigned to support the unit, department, entity, and health system organization

Required Skills and Abilities\n\nAn understanding of HIPAA standards and patient privacy regulations is required. \n\nDemonstrated consultative, team building, and group facilitative skills are required.\n\nThe ability to manage concurrent projects while meeting project deadlines is required.\n\nDemonstrated interpersonal/verbal communication skills are required.\n\nThe ability to utilize computer software is required. \n\nMust be able to work independently, take initiative and persevere in obtaining application documentation while communicating in a professional manner.\n\nMust have the ability to evaluate that the requirements of a completed application have been met.\n\nMust have an understanding of Government plan enrollment policies and procedures.\n\nMust be able to exercise good judgment when escalating issues.\n\nSpecific proficiency with computer software including, but not limited to, spreadsheet and word processing applications (e.g. Microsoft Office Suite) is required

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Posted: 2019-10-18 Expires: 2019-11-17

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901276 Enroll Maintenance Coor

Penn Medicine
Philadelphia, PA 19104

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