Director, Provider Enrollment

Confidential Jobs Clark Freeport and Special Economic Zone, Central Luzon, Philippines5 days ago Be among the first 25 applicantsJob Title : Director of Provider EnrollmentEssential Functions and Tasks : Directs, leads, and manages the Provider Enrollment department's day to day operations, recruits, selects, orients, trains, coaches, counsels, and disciplines staff.Develops relationships with the Provider Enrollment teams and documents needs and organizational priorities.Ensures success of the provider enrollment lifecycle by monitoring client level metrics as well as ensuring timeliness and accuracy of team's enrollment activities related to new enrollment, reenrollment, enrollment denials and client level special projects.Develops relationships with clients and provides regular status updates on credentialing related deliverables.Makes recommendations on work-flow processes throughout the enrollment cycle to assist in achieving consistency and success.Develops and makes recommendations on policies, guidelines, and implements procedures to ensure consistent department-wide implementation and adherence.Holds monthly (or as warranted) meetings with all levels of management to review held claims, status of client provider enrollment, overall provider enrollment inventory, etc.Monitors timeliness and effectiveness of department activities, implements processes to identify gaps.Compiles and prepares a variety of reports for management in order to analyze trends and make recommendations.Performs special projects and other duties as assigned.Education and Experience Requirements : High School diploma or equivalent.Bachelor's Degree in Healthcare Administration, Business Administration, Benefits, or equivalent training and / or experience preferred.At least five (5) years of physician billing, hospital billing, or vendor management experience in provider enrollment functions.At least two (2) years of supervisory / management / leadership experience preferred.Experience with CAQH database, NPI website and maintaining EDI, EFT, and ERA processes preferred.Knowledge, Skills, and Abilities : Knowledge of provider enrollment requirements for physician billing and multi-state experience preferred.Knowledge of business and financial processes, procedures, and processes.Knowledge of medical terminology and anatomy.Knowledge of requirements of medical record documentation.Strong leadership development and team building skills.Strong management level oral, written, and interpersonal communication skills.Strong financial reporting skills.Strong healthcare data analysis skills.Strong presentation development and delivery skills.Strong word processing, spreadsheet, database, and presentation software skills.Strong decision-making skills, problem-solving skills, organizational skills, and time management skills.Seniority Level : DirectorEmployment Type : Full-timeJob Function : Management, Strategy / Planning, and OtherIndustries : Hospitals and Health Care

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