Enrollment Maintenance Coordinator

Responsibilities:

• Works with providers, departments, and Professional Billing Office (PBO) staff to complete provider enrollment process in a timely and efficient manner in accordance with service standards. Assists with communication of follow-up notices to provider and departments.
• Prepares and maintains indemnity enrollment files for new providers. Completes, submits and follows up on indemnity applications sent to the assigned health plans for enrollment into their network.
• Ensures that applications are accurately processed by the health plans. Works with the plan to ensure their information needs are met and that they provide provider numbers on a timely basis.
• Enters data in enrollment database in a timely and accurate manner. Maintains proficiency in utilization of enrollment and credentialing database. Analyzes the various Enrollment Reports for assigned plans to ensure that the providers’ enrollments have been completed with the health plans.
• Maintains proficiency in utilization of enrollment databases and other systems required for enrollment with assigned health plans (e.g. PECOS, Promise). Performs data entry of provider numbers into enrollment database as necessary.
• Serves as liaison between the departments/practices and health plans in order to resolve enrollment issues. Researches 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.
• Assists Lead, Payer Supervisor and Senior Enrollment Manager with specific projects and special enrollment request by PBO (i.e. Workers Compensation and Out of State Medicaid enrollment).
• Performs duties in accordance with Penn Medicine and entity values, policies, and procedures.
• Other duties as assigned to support the unit, department, entity, and health system organization.

Education/Experience:

• H.S. Diploma/GED (Required)
• 3+ years of experience working in a similar position, preferably in a health care organization (Required)

Skills & Abilities:

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