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The Enrollment Specialist manages commercial and government payor enrollment functions to maximize reimbursement and maintain provider database integrity. They serve as a primary point of contact for providers and internal departments regarding enrollment status and pertinent regulatory information.
JOB DESCRIPTION:
The Enrollment Specialist performs commercial and government payor enrollment functions for all University of Vermont Health Network entities in accordance with the State of Vermont, State of New York, State and Federal Statutes, TJC, NCQA, CMS, and contracted managed care payors. The Enrollment Specialist interacts with providers, office staff, internal departments within each Affiliate of the UVM Health Network, and contracted payors. The Enrollment Specialist is also responsible for data entry, integrity and maintenance of the provider database. The Enrollment Specialist is responsible for notification to providers, internal UVM Health Network departments, Department Leadership, government entities, and contracted payors of all pertinent information related to the enrollment of a provider. The Enrollment Specialist is responsible for managing the enrollment process for all billing providers to maximize reimbursement and decrease AR. The Enrollment Specialist obtains and maintains provider ID numbers.
EDUCATION:
Must possess Associate's degree in business, related degree, or professional experience equivalent, Bachelor's degree preferred. Work experience may be considered as substitute to degree. PESC certified recommended.
EXPERIENCE:
Three years’ experience in an administrative or health care related field preferred. Direct experience with Provider Enrollment functions and database management preferred.
The role of Enrollment Specialist includes multiple levels. The hiring team reserves the right to determine appropriate level placement of our final candidate. Level and salary upon hiring are commensurate with years of relevant experience. Please reach out to recruitment for information on levels and corresponding compensation.
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