Government Enrollment Specialist Managed CareAltamonte Springs, FL

Government Enrollment Specialist

Hospitals, medical centers and facilities need more than physicians, nurses and specialists delivering care to our patients. A truly successful health care organization needs a thoughtful, dedicated, steady and experienced team working behind the scenes to make sure communities around the country receive the health care they need.

If you've also been interested in working in the health care field but aren't a health care provider, a corporate career at AdventHealth may just be the perfect fit. We're a faith-based health care organization headquartered in Altamonte Springs, Florida. As a national leader in quality, safety and patient satisfaction, our 92,000 team members maintain a long tradition of whole-person health by caring for the physical, emotional and spiritual needs of every patient.

Start your journey with a health care career at AdventHealth Corporate.

Every day, our fellow team members show up to work, unified by one shared mission : Extending the Healing Ministry of Jesus Christ. As a faith-based health care organization, our story is one of hope as we strive to heal and restore the body, mind and spirit. Though our facilities are spread across the country, this unwavering belief binds us together. Across every office, exam and patient room, we're committed to providing individualized, holistic care. This is our Christian mission, and it inspires us to help make communities healthier and happier.

All the benefits and perks you need for you and your family :

Benefits from Day One

Career Development

Whole Person Wellbeing Resources

Mental Health Resources and Support

Shift : Monday-Friday Full time 8am-5pm EST

Job Location : Remote

The role you will contribute :

Coordinates the day-to-day administration of Adventist Health System's (AHS) Medicare and Medicaid provider enrollment program, ensuring that all existing and new physicians and other billing health care providers in the AHS system are enrolled in compliance with all affiliation and participation requirements, as well as regulatory and internal policy requirements.

The value you will bring to the team :

• Collaborates with other departments, such as provider onboarding, credentialing, and revenue cycle, to gather necessary information and ensure a smooth application process.
• Offers support and guidance to provider onboarding throughout the application process, answering questions, providing updates on application status, and assisting with any issues.
• Monitors the status of all applications, following up with regulatory agencies as needed to ensure timely processing and approval, and maintaining a tracking system to monitor progress.
• Acts as the primary point of contact with Medicare / Medicaid regulatory agencies, submitting applications, responding to inquiries, and addressing any issues that arise during the approval process.
• Identifies any issues or delays in the application process and works to resolve them promptly, troubleshooting problems, coordinating with other departments, or escalating issues to higher management.
• Demonstrated skills in attention to detail and accuracy, while maintaining required productivity.
• Demonstrated strong interpersonal skills and ability to work effectively at all levels in a collaborative team environment.
• Reviews and verifies all documentation submitted by new physicians and advanced practitioner providers to ensure completeness and accuracy, contacting applicants for additional information or clarification if needed.
• Other duties as assigned.
• Ensures that all new physicians and advanced practitioner providers are enrolled in Medicare / Medicaid programs in a timely manner, allowing them to begin billing for services as soon as possible.
• Prepares for and assists with internal and external audits related to the Medicare / Medicaid application process, ensuring that all records are accurate and up-to-date and providing any requested documentation to auditors.
• Continuously evaluates the application process and recommends improvements to increase efficiency and compliance, updating procedures, implementing new technologies, or providing training to staff.
• Oversees the entire Medicare / Medicaid application process for new physicians and advanced practitioner providers, ensuring timely and accurate submission of all required documentation.
• Ensures that all applications comply with federal, state, and organizational regulations and policies, staying updated on any changes in Medicare / Medicaid requirements and implementing necessary adjustments.
• Keeps accurate and organized records of all applications, including tracking the status of each application, maintaining copies of submitted documents, and recording any communications with regulatory agencies.

The expertise and experiences you'll need to succeed :

High School Grad or Equiv

3 Years Work Experience

Attentive to detail and accuracy; strong organization skills required.

Working knowledge and understanding of all rules, regulations, policies, and procedures with regard to health care professional billing under Medicare / Medicaid.

Ability to communicate effectively, both orally and in writing.

Analytical, evaluative, and critical thinking skills.

Knowledge and understanding of electronic data collection and data management systems and procedures.

Ability to prioritize and manage a demanding workload.

Working familiarity with Medicare / Medicaid provider billing requirements in all states where AHS has provider medical groups.

Knowledge of AHS medical practice billing procedures and systems as they relate to Medicare / Medicaid.

Skill in the use and administration of specialized electronic medical billing applications.

Strong interpersonal skills and ability to work effectively at all levels in a collaborative team environment.

Preferred Qualifications :

Associate Degree

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

Category : Managed Care

Organization : AdventHealth Corporate

Schedule : Full-time

Shift : 1 - Day

Req ID : 25037191

We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability / handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.