Job Information
LogixHealth Senior Enrollment Implementation Manager in Bedford, Massachusetts
Purpose
To provide a professional and efficient enrollment experience to new clients that are onboarding with LogixHealth. To manage a team that will assist with all tasks that associate with onboarding new clients.
Duties and Responsibilities
Oversee and manage staff that will work solely onboarding new clients
Complete and attend billing questionnaire calls and work directly with clients to ensure LogixHealth receives appropriate documentation for enrollment purposes
Review all documents received to make sure that the legal name matches on all documents and there are no discrepancies
Communicate with internal departments on progress of enrollment for all new clients and assign/complete any associated tasks within Microsoft Teams Internal New Client Billing Operations channel
Work with clients verifying ownership structure and then report the structure to the respective state Medicaid and Medicare
Identify any outliers that clients may have in their reporting structure for example, malpractice suits, sanctions and/ or reportable outliers
If needed, assist owners of organizations through the identity proofing process with CMS
Explain what this is, giving clients detailed definitions and purposes of why I&A/ PECOS platform is necessary for successful enrollment
This process includes setting up meetings with clients, screen sharing so that set up is successful
Initiate and manage all new client enrollment meetings during the implementation period
These meetings may be weekly/bi-weekly/ monthly dependent on the client
During these calls, the client will be provided a list of required items to ensure accurate enrollments
The LogixHealth enrollment process will be clearly communicated with education on state specific enrollment requirements provided to the client if necessary
A SharePoint/ One Drive excel will be created based upon received information that will be used to assist in tracking all individual provider identity required documents
New provider profile packets will be created specific to each client
Assign an audit of all providers associated with the new client to make sure their enrollments are accurate, approved and entered in the LogixHealth system accurately
Review/ sign off on audit before new client is released to permanent enrollment representative
Work directly with offshore team to ensure all assignments are on track for completion, including Symplr/ Allscripts data entry
Assign and manage the CAQH process for all individual providers associated with new clients
Submit all group level applications for new clients onboarding, including but not limited to, Medicare, Medicaid and BCBS
If a client resides in multiple states enrollment will need to be completed for each state
Submit all individual provider enrollment applications with payers as necessary
Manage and work with team as they identify any providers that are not enrolled/ active with applicable payers that the client is contracted with, as well as complete an out of network enrollment if necessary
Manage/submit all clients Medicare revalidations at the group level
Complete a client transfer training with a Provider Enrollment Representative once the onboarding process is complete
Complete/ Maintain SOP that pertains to new client processes
Resolve any department issues with department Associate Director/ Director/Senior Director
Attend regularly scheduled meetings
Assign work to staff and ensure completion
May delegate day to day oversight to supervisors or team leads
Ensure staff is trained and aware of job and company expectations and determine remedial action when needed
Ensure cooperative team environment by
Effectively communicating with staff about department and company initiatives
Adjusting procedures as necessary to create process efficiencies
Resolving issues among staff
Encouraging constructive feedback from staff and between team members
Manage recruitment process including
Identifying needs
Posting internally
Screening and interviewing candidates
Comply with all State and Federal Laws regarding an effective Compliance Program inclusive of HIPAA Privacy and Security
Adhere to the Code of Conduct and be familiar with all compliance policies and procedures stored in LogixGarden relevant to this position
Ensure departmental employees follow the Code of Conduct, compliance policies and procedures
Administer the appropriate sanction when an employee violates a compliance policy or procedure
Review and approve time and attendance records according to company standards
Provide on-going feedback and annual performance reviews
Uphold company mission, vision and values
Proactively monitor company policies and address transgressions appropriately
Facilitate meetings within department and make presentations to senior management as needed
Monitor and enforce compliance with all pertinent local, state, and federal laws and regulations relating to operations and employment
Qualifications
To perform this job successfully, an individual must be able to perform each duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities perform the duties.
Education (Degrees, Certificates, Licenses, Etc.)
Bachelor’s degree or equivalent combination of education and experience required.
Computer Skills
Prior word processing, spreadsheet and internet software experience including proficiency with MS Excel and MS Word required.
Experience
2 - 4 years of related experience in a healthcare setting preferred.
Specific Job Knowledge, Skill and Ability
Ability to handle client and provider information discreetly and confidentially
Ability to organize information with a strong attention to detail
Ability to build and maintain strong client/provider relationships
Ability to comprehend and communicate contract information
Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedural manuals
Ability to write routine reports and correspondence
Ability to communicate effectively verbally and in writing
Ability to apply common sense understanding to carry out instructions
Specific vision abilities required by this job include close vision
Ability to sit for prolonged periods of time, use hands, talk, hear and occasionally walk and reach with hands or arms
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