Current UPHS employees must apply HERE
Enroll Maintenance Coordinator
Job ID: 183418
Category: Human Resources
Work Type: FT
Location: Philadelphia, PA, United States
Date Posted: May 22, 2023
Work Schedule: Monday thru Friday from 8:00am-4:30pm - Hybrid
Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.
Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?
The 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).
- Works with providers, departments, and Professional Billing Office staff to complete provider enrollment process in a timely and efficient manner in accordance with service standards.
- Works with health plan staff to ensure their information needs are met and that they provide provider numbers on a timely basis
- Completes, submits and follows up on managed care exports and/or indemnity applications sent to the assigned health plans for enrollment into their network
- Ensures that provider and practice changes are submitted to the assigned health plans and are accurately processed by the health plans
- Performs special projects and/or runs reports to support the provider enrollment process for the assigned health plans
- Maintains proficiency in utilization of enrollment databases and other systems required for enrollment with assigned health plans (e.g. PECOS, Promise)
- Serves as liaison between the departments/practices and health plans in order to resolve enrollment issues
- Analyzes the various Enrollment Reports for assigned plans to ensure that the providers’ enrollments have been completed with the health plans
- 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
- 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
Required Education and Experience
- H.S. Diploma/GED is required
- 3+ years of working in a similar position, preferably in a health care organization is required
Required Skills and Abilities
- REGULATORY: Understanding of HIPAA standards and patient privacy regulations
- COMMUNICATION: Demonstrated consultative, team building, and group facilitative skills
- PROJECT/CHANGE MANAGEMENT: Ability to manage concurrent projects while meeting project deadlines
- COMMUNICATION: Demonstrated interpersonal/verbal communication skills
- TECHNOLOGY: 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)
Department: Medical Affairs - Admin
Position Address: 3600 Civic Center Blvd
We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.
Live Your Life's Work
We are an Equal Opportunity and Affirmative Action employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.
Current UPHS employees must apply HERE