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**Join UMC Physicians: Where Employee Satisfaction Soars at 98%!**

Summary:
Title: Enrollment Specialist
Department: Managed Care

The Enrollment Specialist facilitates the payer applications from a new/existing provider through all stages in order to enroll or re-validate the provider’s with commercial, delegated and government payers. The Enrollment Specialist is also responsible for updating practitioner information in both the internal software and with external payers. In addition to data entry, the specialist also maintains copies of licensure, certificates, and other documents necessary for the enrollment process, maintains provider CAQH profiles, and conducts verification of all data, ensuring accuracy and timely entry of information. The enrollment specialist shares essential updates with providers and the internal team as necessary. Decisions will have a direct impact upon the efficiency and effectiveness of enrollment and upon direct staff. Decisions also have the potential to impact payer rosters and billing services. Must function mostly independently with a strong awareness of the interactions and interdependency of all areas.

Preferred Characteristics:
• Must be able to multi-task
• Excellent organizational skills and must be detail-oriented
• Proficiency in Microsoft Office
• Strong computer and typing skills
• Positive, friendly, approachable disposition
• Ability to work with multiple priorities

Availability Requirements:
• Ability to work 40 hours per week, on-site
• Monday - Thurs, 8:00 a.m. - 5:00 p.m.; Friday 8 a.m.-12 p.m.

Our Mission: To improve the quality of life for our community by providing the best patient experience for every patient.

Our Vision: To be the best place to work and the best place to receive healthcare.

Benefits: UMC Physicians offers a comprehensive benefits package to eligible full-time employees. Benefits include:
• Paid Time Off
• Sick Pay
• Medical, Dental and Vision Insurance
• Employer Paid Group Life and Voluntary Life Insurance
• Short Term Disability Insurance
• Long Term Disability (after 2 years of employment)
• Critical Illness, Accident and Cancer Insurance
• Health Care and Dependent Care Spending Accounts
• 401K Retirement Plan with Company Match
• Employee Assistance Program
Note: Some benefits require an employee contribution to participate.

Job Description:
• Conducts the enrollment process and maintains accurate and up to date
provider information in CredentialStream platform and Teams software
• Adheres to deadlines and enrollment schedules by tracking enrollment
through all stages
• Communicates with providers, payers, UMC Medical Staff Office and UMC
Managed Care via email, phone and mail
• Helps the department transition to digitized workflows
• Maintains confidentiality and responsibility for all enrollment files through
the process
• Maintains an organized database of physician information, ensuring
accuracy and completeness.
• Ensures that all enrollment activities adhere to healthcare regulations, best
practices and organizational policies.
• Collaborates with UMCP, UMC departments and billing to facilitate the
enrollment process.
• Addresses and resolve enrollment-related issues and discrepancies
promptly.
• Generates reports and documentation related to physician enrollment, as
needed.
• Maintains workflows for provider enrollment within CredentialStream
platform.
• Other duties as assigned

Job Requirements:
• Strong communication skills for speaking with payers, facilities, medical
billing staff, and providers via telephone or in person
• Willingness to establish and maintain effective work relationships with
providers, payers, Medical Staff Office’s, co-workers, supervisors,
managers and directors
• Ability to analyze, interpret, and draw inferences from research findings
and prepare reports
• Ability to work independently in a fast-paced environment while remaining
calm and professional
• Database management skills, including generating queries, reports, and
documents

Job Recommendations:
• Basic knowledge of medical credentialing and privileging procedures

Required Education:
• High School Diploma

Recommended Work Experience:
• 2 years related experience and/or training (but not required); Training
provided

Environmental Conditions:
Works in well-lighted, heated and ventilated building. Exposure to blood borne pathogens are of low risk. Hours of duty may be irregular.

Physical Requirements:
Work is of medium demand; walking and sitting most of the time while on duty. Adequate hand/eye coordination and fine motor skills required. Visual acuity and writing skills necessary for factual documentation. Hours may vary to accommodate needs of the corporation.

Limitations and disclaimer:
The above job description is meant to describe the general nature of work being performed; it is not intended to be construed as an exhaustive list of all responsibilities, duties and skills required for the position.
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UMC Health System provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment on the basis of race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

*Request for accommodations in the hire process should be directed to UMC Human Resources.​*