Lead Enrollment & Reimbursement Coordinator

We are seeking a Lead Enrollment & Reimbursement Coordinator who will provide on-going training and support to Enrollment Reimbursement Coordinators, physicians, non-physician providers and other personnel on provider enrollment and credentialing requirements.
Works in close collaboration with the clinical departments, Physicians Billing Service, and the Johns Hopkins Central Credentialing Office.
Prepares reports for the Director of Provider Enrollment, Provider Enrollment Manager and clinical departments regarding the status of provider's payor enrollments.
This position serves as a lead enrollment coordinator for Government enrollment.
Specific Duties & Responsibilities Serves as team lead responsible for reviewing and analyzing the accuracy of staff work related to government payor enrollments.
Conducts independent reviews/audits on the adequacy of government payor enrollments.
Ensure staff enroll/reenroll all active providers prior to their projected start/revalidation dates.
Assists manager and enrollment coordinators in developing corrective action plans to improve.
Serves as a resource for staff questions.
Assist in training new staff and existing staff members.
Provide feedback regarding problems to Provider Enrollment Manager and assists in problem resolution.
Generate weekly and monthly productivity reports.
Originates ad hoc data reports and summarizes results.
Audits payer websites for erroneous or missing provider profile data.
Audits SER information and updates provider dictionaries effectively.
Enrolls School of Medicine CPA Faculty and ancillary support staff with government payers timely and accurately Follows Medicare PECOS Provider Enrollment Policy and escalates cases when providers have not responded within specified timeframe.
Reviews and resolves provider enrollment related rejections daily Reviews Provider Enrollment Charge Edits timely to identify and enroll providers who need to be enrolled with government payors.
Reviews Provider Enrollment Related Claim Edits timely to ensure providers with outstanding enrollments are captured and resolved quickly.
Ensures Epic SER records, NPPES, ePREP, and all other government payor databases are updated with provider's most current billing related information timely and accurately.
Communicates with the Enrollment Manager regarding enrollment applications that are returned to identify issues and cases for appeal.
Investigates enrollment impacted third party claims rejections and patient referral denials.
Third party liaison between production units and insurance networks.
Coordinates all aspects of JHU-CPA individual provider participation with health insurance carriers under their respective delegated credentialing agreements.
Assures information obtained and transmitted on providers is accurate and timely, to maximize potential revenue through validated participation in payer's and JHU's respective IS-systems.
Monitors and/or maintains process by which providers are recognized and enrolled with payers and satisfactorily set-up in Epic.
Oversees data integrity in the Epic billing system provider dictionary for key billing provider identities.
Serves as principle liaison to JHM hospital's respective Medical Staff Offices and the JHM CCO to address status changes, location, etc and the corresponding impact on billing procedures.
Resolve disputes, discrepancies and other provider enrollment related problems, as necessary.
Specific Knowledge, Skills & Abilities Proficient in use of Excel.
Excellent organizational skills Strong analytical/problem solving skills required.
Excellent oral and written communications skills required.
Ability to interact with all levels of staff.
Minimum Qualifications Bachelor's Degree required.
Two year's experience in a specialty billing area or previous medical billing experience in similar environment is required.
Professional credentialing for commercial and governmental health plans experience required.
Additional education may substitute for required experience and additional experience may substitute for required education, to the extent permitted by the JHU equivalency formula.
Preferred Qualifications Knowledge of the Epic billing system.
Classified Title: Enrollment & Reimbursement Coordinator Job Posting Title (Working Title): Lead Enrollment & Reimbursement Coordinator Role/Level/Range: ATO 40/E/02/OE Starting Salary Range: $18.
00 - $33.
50 HRLY ($54,205 targeted; Commensurate with experience) Employee group: Full Time Schedule: M-F 8:30 AM - 5 PM Exempt Status: Non-Exempt Location: Remote Department name: SOM Admin CPA Contract Services Personnel area: School of Medicine