Job Summary
This position reports to the Manager of Provider Enrollment which is part of the Compliance Division in the Revenue Cycle Department. The Provider Enrollment Clerk will be responsible for new hire payer enrollments and revalidations of all Michigan Medicine physician and non-physician practitioners for whom we submit claims. The Provider Enrollment Clerk is committed to ensuring that data required to complete enrollment for all billing providers is entered into the appropriate systems in an accurate and timely manner. The position will understand and stay current with payer requirements for information completion to ensure continuous flow of revenue to the institution.
The Provider Enrollment Clerk position is data entry focused where work will be prioritized based on timeframes when due, using Cactus, CHAMPS, PECOS, or other generated work lists. Success will be measured by quality and quantity metrics and positive and active engagement towards process improvement. The Provider Enrollment Clerk will be a partnership, which will include collaborating and sharing work with a teammate. The Provider Enrollment Clerk will participate in ongoing workflow process documentation and redesign. The Provider Enrollment Clerk position may have some responsibility for OOS enrollments where process with the State is well established.
The Provider Enrollment Clerk is primarily a remote position. There is some flexibility in working hours. The business office is in the Eastern Time Zone and work hours must accommodate interactions, for example staff meetings. On occasion it may be necessary for this position to work onsite to obtain mail or other correspondence, perform special tasks, attend meetings, or if there are computer or technology issues that prevent working remotely. High speed internet is required to perform the job duties.
Mission Statement
Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.
Responsibilities*
- Compiles and maintains current and accurate data for all providers in accordance to standard procedures
- Completes provider enrollment and revalidation applications; monitors applications and follows-up as needed, including utilizing Cactus queries and reports
- Cactus data entry of provider enrollment items required for new hires
- I&A Access Requests for New Hire, Revalidations, and Change of Information, including Cactus Contracts/Plans, and terminations when providers leave.
- NPPES for New Hire, Revalidations, and Change of Information, including Cactus Contracts/Plans, and terminations when providers leave.
- Medicare PECOS Enrollments and Revalidations, (855I and 855R), for New Hire, Revalidations, and Change of Information, including Cactus Contracts/Plans, and terminations when providers leave.
- CHAMPS Enrollments and Revalidations (Individual), for New Hire, Revalidations, and Change of Information, including Cactus Contracts/Plans, and terminations when providers leave
- CHAMPS Domain Administrator for enrollment including Professional Service Agreement (PSA) entities and providers when working for other employers.
- OOS Medicaid enrollments and revalidations for States where process is well established
- Resolves routine problems, escalate to manager when appropriate
- Perform special tasks as assigned
- Follow standard operating procedures including centrally filing and storing information used by others in the department
- Protect and secure personal identifying attributes for UMHS Board Members, Managing Employees, Providers, and Patients (PHI) when communicating with payers.
- Contributes to department improvement initiatives including the utilization of automation and technology to improve accuracy and efficiency
- Speaks up when there is a safety concern
Required Qualifications*
- High school diploma or equivalent
- Minimum 5 years of experience in a healthcare or revenue cycle related field
- Minimum 2 years of provider enrollment experience
- Demonstrated ability to perform provider enrollment functions using a variety of mediums including payer web based portals and securely transferring information to external parties
- Ability to manage and navigate required enrollment portals, including managing passwords and facilitating access for others
- Knowledge of payer enrollment requirements
- Excellent computer application skills with the ability to utilize current technology
- Ability to work remotely in an efficient and productive manner, including using Teams, Zoom, Cisco Jabber, AccuRoute Desktop Fax Server
- Strong dedication to customer service, ability to be flexible and work within a team-focused approach
- Demonstrated ability to embrace the High Reliability Organization approach including "Know Why and Comply" concept
Desired Qualifications*
- Provider Enrollment knowledge
- Provider Enrollment Software knowledge
- Group and Individual NPI knowledge
Modes of Work
Positions that are eligible for hybrid or mobile/remote work mode are at the discretion of the hiring department. Work agreements are reviewed annually at a minimum and are subject to change at any time, and for any reason, throughout the course of employment. Learn more about the work modes.
Background Screening
Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings. Background screenings are performed in compliance with the Fair Credit Report Act. Pre-employment drug testing applies to all selected candidates, including new or additional faculty and staff appointments, as well as transfers from other U-M campuses.
Application Deadline
Job openings are posted for a minimum of seven calendar days. The review and selection process may begin as early as the eighth day after posting. This opening may be removed from posting boards and filled anytime after the minimum posting period has ended.
U-M EEO/AA Statement
The University of Michigan is an equal opportunity/affirmative action employer.
