Enrollment Specialist
About the role
The Enrollment Specialist performs commercial and government payor enrollment functions for all University of Vermont Health Network entities in accordance with State of Vermont, State of New York, State and Federal Statutes, TJC, NCQA, CMS, and contracted managed care payors. The role involves interacting with providers, office staff, internal departments within each Affiliate of the UVM Health Network, and contracted payors. Responsibilities include data entry, integrity, and maintenance of the provider database, as well as notifying providers, internal departments, leadership, government entities, and payors of pertinent enrollment information. The Enrollment Specialist manages the enrollment process for all billing providers to maximize reimbursement and decrease accounts receivable (AR) while obtaining and maintaining provider ID numbers.
Responsibilities
- Perform commercial and government payor enrollment functions in compliance with applicable statutes and regulations.
- Interact with providers, office staff, internal departments, and contracted payors.
- Maintain data integrity and accuracy of the provider database.
- Notify relevant stakeholders (providers, internal departments, leadership, government entities, and payors) of enrollment-related information.
- Manage the enrollment process for billing providers to optimize reimbursement and reduce AR.
- Obtain and maintain provider ID numbers.
Requirements
- Associate's degree in business or a related field, or equivalent professional experience; Bachelor's degree preferred.
- Work experience may substitute for a degree.
- PESC certification recommended.
- Three years’ experience in an administrative or healthcare-related field preferred.
- Direct experience with provider enrollment functions and database management is a plus.