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Enrollment / Eligibility Specialist
Mobile, AL
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Business Office Coordinator AltaPointe Health - 3.0 Mobile, AL Job Details Full-time 10 hours ago Qualifications Staff supervision Spreadsheets Team management Productivity software
Full Job Description Overview:
AltaPointe Health is hosting Open Interviews on Thursday, August 27th from 10:00AM-2:00PM. This event will take place at EastPointe Hospital (7400 Roper Ln; Daphne, AL 36526). Please make sure your application is updated prior to this event. When you arrive you will be able to interview with a Recruiter who can talk about all our open positions. -AltaPointe Recruitment Team AltaPointe Health Systems is a comprehensive behavioral healthcare and psychiatric hospital system. Our continuum of care includes two psychiatric hospitals, multiple behavioral health, and primary care outpatient locations, and residential services. This position is responsible for working with billing and enrollment teams to manager denials and enrollment application processes for all AltaPointe Health System providers with all applicable commercial, federal, and state payer plans.
Responsibilities:
Provide input into internal processes with the Business Office department, ensuring timeliness and completeness of all billing outputs. Support oversight of Accounts Receivable processes, focusing on billings, collections, enrollment, and related reporting. Oversees the production capability of the provider enrollment department Plan and control effective practices to ensure that all providers are enrolled accurately with applicable payers in a timely manner Implement and monitor compliance with all revenue cycle and departmental specific policies and procedures, ensuring maximum effectiveness by lowering enrollment denials and rejections. Respond to third-party inquiries/complaints and determine and initiate appropriate action Ensure staff is productive by tracking productivity measures Actively participate in all functions relating to the administrative work in coordinating the enrollment and re-enrollment process of providers with the Alabama Department of Mental Health, Medicaid, Medicare, and other third-party payers Ensure accurate enrollment applications for new providers are completed in a timely manner. Maintain accurate information with regards to the re-enrollment standards for all payers. Ensure re-enrollment applications are submitted in a timely manner to ensure that providers are up to date with their re-enrollment status. Follow up with the contractual insurance carriers regarding provider/facility enrollment/termination/relocation status. Enroll all providers in CAQH and provide re-attestations as needed Maintains the Provider Enrollment Database Issues monthly reports from the the database to ensure proper communication regarding provider status related to enrollment Provides additional status reports and updates as needed. Updates the appropriate provider enrollment matrix. Tracks progress of outstanding applications and inform the appropriate parties of in-network effective Work with Human Resources to keep the database as accurate as possible. Communicates and Coordinates efforts with outside billing companies and the AltaPointe billing department to ensure billing denials due to enrollment issues are addressed in a timely manner. Communicates with internal management, providers, and departments in regards to the enrollment process Proactively communicates with Human Resources in regards to the needs/requirements of the enrollment department as it relates to provider Works closely with providers to obtain the necessary Assists providers in obtaining/updating an NPI number. Coordinate and communicate with the billing and enrollment teams Collaborates with the billing department to resolve any provider based denial issues related to the enrollment process. Communicates with appropriate billing staff regarding the status of a provider's enrollment with individual payers. Any significant delays must be reported to management Assists with the maintenance of the Practitioner Enrollment forms in electronic systems in a timely manner. Courteous and respectful towards consumers, visitors, and co-workers Treat consumers with care, dignity, and compassion Respect consumers' privacy and confidentiality Is pleasant and cooperative with others Assist consumers and visitors as needed Personal values don't inhibit the ability to relate and care for others Is sensitive to the consumer's needs, expectations, and individual differences Is gentle and calm with consumers, families, and others as appropriate Administrative and Other Related Duties as assigned: Actively participate in Performance Improvement activities Actively participate in AHS committees as requested Complete assigned tasks in a timely manner Follow AHS policies and procedures Receive and respond to inquiries of billing and enrollment matters promptly and courteously. Assist with performance of duties of other staff in periods of absence. Perform other duties as assigned.
Qualifications:
Bachelor's degree in business or related field; two years of related experience preferred. Applicant must have a working knowledge of
MS Office:
Excel, Word, etc. Applicant must have excellent verbal and written communication skills. Experience with provider enrollment, insurance billing and/or healthcare financial operations preferred. Proven supervisory skills, excellent organizational skills and attention to detail required.