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Job Title Enrollment and Project Management Assistant
Location Southfield, MI
Department Coding and Billing
FLSA Status Non-Exempt
Shifts hiring Full-time


GENERAL SUMMARY

Under the general supervision of the Administrative Billing Supervisor and the Executive V.P. of Business Administration, directs and coordinates enrollment of all ambulance services contracted health plan networks and government programs. Develops, maintains, and monitors project plans for assigned projects, including new accounts and companies.

 

PRIMARY RESPONSIBILITIES AND DUTIES

The following essential duties and responsibilities are not all inclusive.  Other responsibilities and duties may be assigned. 

  1. Coordinates the enrollment of all ambulance service for Parastar clients in contracted insurance company networks and government agencies.  Completes and submits necessary documentation, including but not limited to Michigan Health Plan Standard Credentialing Applications, insurance company-specific forms, contracts, copies of provider licenses and such other documentation as is necessary for enrollment or the credentialing process.  Follows up with insurance companies and government agencies to ensure completion of the process in a timely manner.   
  2. Obtains and reviews necessary information from various sources, including Risk Management, Parastar client organizations, and regulatory agencies to ensure compliance with enrollment requirements. 
  3. Coordinates enrollment and maintenance of provider information in the Counsel for Affordable Quality Healthcare (CAQH) Universal Credentialing Data source for all applicable clients.
  4. Maintains close communications with necessary staff members and clients to ensure prompt collection of information to expedite the enrollment process.

 

 PRIMARY RESPONSIBILITIES AND DUTIES CONTINUED

The following essential duties and responsibilities are not all inclusive.  Other responsibilities and duties may be assigned. 

 

  1. Organizes and schedules workflow to meet established deadlines. Refines tracking mechanisms for application files at various states of processing.
  1. Manages internal credentialing database. Develops statistical and other reports necessary to report on status to various internal customers.  Uses a database on a daily basis to maintain credentialing status.  Reports concerns or issues to the Executive V.P. of Administration immediately.
  2. Oversees, develops and maintains up-to-date computer programs to record confidential credentials information and statistics for all currently approved staff members to be used for credentialing purposes and both internal and external inquiries as appropriate.
  3. Responsible for completing applications for insurance re-credentialing requests for all clients.
  4. Serves as a resource to staff and clients with respect to provider enrollment, insurance credentialing and related billing and collection issues and functions.
  5. Follows legal, State and Federal agency, State licensing board, and Risk Management guidelines, and/or regulations in administering credentials verification process.
  6. Develops and maintains project plans as assigned, including new client start-up and new company start-up.
  7. Utilizes project planning software and submits status reports to leadership.
  8. Organizes meetings as assigned.

14. Exhibits excellent customer service skills and behaviors toward internal and external customers and co-workers. 

15. Adheres to department customer service, service excellence, and performance standards.

  1. 16.  Demonstrates personal commitment to the Organization’s core values through active involvement in the performance improvement process.
  2. 17.  Demonstrates safe work practices and attitudes, follows safety rules, works to prevent unsafe conditions and behaviors, and participates in organizational and departmental safety programs.

 

MANAGEMENT RESPONSIBILITIES

This position has no responsibility to manage or lead a team.

 

EDUCATIONAL AND CERTIFICATION REQUIREMENTS AND WORK EXPERIENCE

  1. Minimum Education: High school diploma with concentration in business / secretarial courses. 
  2. Minimum Work Experience: Minimum of two to four years in a secretarial, clerical, or related position.  Previous credentialing experience preferred.  Previous experience with facility/professional/clinic billing processes and claims resolution preferred.
  3. Certification, Licensure, Registration: None required.

 

KNOWLEDGE AND SKILLS REQUIRED

  1. Contacts with Others:   Ability to communicate effectively with clients, insurance companies, vendors, support staff of hospitals, crew members, other department staff and management staff.
  2. Analytical Demands: Ability to plan and organize materials and information necessary in the Professional staff credentialing process.

 

WORKING CONDITIONS

  1. Physical Effort: Mental/visual stress related to viewing of computer screens and printed material for prolonged periods. Lifting limited to a box of forms weighing 7-8 pounds. Prolonged periods of sitting.
  2. Work Environment: Normal office environment with limited exposure to health or accident hazards.
  3. Equipment Used: Computer, telephone, collection system, printer, calculator, typewriter, fax machine, copy reproduction equipment, e-mail, spreadsheet software.  Familiarity with all Microsoft Office programs including Microsoft Access and advanced internet skills.

Community EMS utilizes Direct Deposit for compensation.  As a condition of employment, all employees must designate a financial institution equipped to accept direct deposits and the number of the account into which the deposit is to be made. 

 


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