Provider Enrollment Specialist - Revenue Cycle

Location

Type, TX | United States

Job description

JOB SUMMARY:

The Revenue Cycle Department at UT Southwestern Medical Center has a new opportunity available for the role of Provider Enrollment Specialist. The duties will include but are not limited to the following:

• Enrolling and maintaining provider information in the billing systems for State and Federal government programs (e.g., Medicare, Medicaid and/or Children with Special Health Care Needs (CSHCN), out-of-State Medicaid) associated with the UT Southwestern Medical Center (“UTSW”).
• Work with department coordinators to gather information for accurate provider enrollment
• Contact TMHP/CMS for PIN and deficiencies
• Update provider Taxonomy, Group info, new group addresses in CACTUS, TMHP, and CMS. 
• Experienced with the following Microsoft products; Word, Excel, and PowerPoint. Work efficiently Excellent time management skills 
• Shift: 0800-5:00pm 
• Work from home (WFH): This is a WFH position but live within the state of Texas. Additional details shall be discussed during the interview process with the hiring team. 

Quick tip(s):

• Please review the section entitled experience/education and focus on the job requirements.
• Please include the experience listed under the “required” section on your application. 

Why UT Southwestern?

With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to provide the best possible care, resources, and benefits for our valued patients and employees. With over 20,000 employees, we are committed to continuing our growth with the best professionals in the healthcare industry. We invite you to be a part of the UT Southwestern team where you’ll discover teamwork, professionalism, and consistent opportunities for growth. 

EXPERIENCE | EDUCATION:

REQUIRED:

• Bachelor’s degree and a minimum of two (2) years applicable work experience.
• Or an Associate’s degree and a minimum of four (4) years applicable work experience.
• Or High School graduate and a minimum of six (6) years applicable work experience required.
• Applicable work experience must be primarily provider enrollment focused. 

JOB DUTIES:

Completes enrollment of all providers/groups for all government programs, such as Medicare, Texas Medicaid, CSHCN, State Medicaid programs outside of Texas and TRICARE. Enrolls new clinic and/or department groups to Electronic Data Information and Electronic Funds Transfer systems. Updates IDX and Cactus programs of government provider number received. Tracks and logs all enrolling providers on government spreadsheets sending it to all clinical departments. Analyzes various information systems EPIC, IDX Provider Edit reports and Provider information Unit enrollment status reports. Resolves editing issues from Billing Operations department pertaining to enrollment. Makes recommendations to management regarding billing enrollment administration and maintenance to improve effectiveness and efficiency of provider billing environment and re-enrollment. Acts as liaison for Provider Enrollment Unit with other billing and/or clinical departments and with appropriate government agencies in support of group and provider enrollment and maintenance. Assists with implementation of projects regarding provider enrollment and re-enrollment, maintains provider billing enrollment information and units’ provider enrollee filing system. Assists other UTSW Health System departments on an as needed basis. Trains new staff on maintenance of IDX, Cactus and EPIC system; billing enrollment application processing guidelines; department policies and procedures; and policies and producers used by federate and state program agencies. Performs other duties as assigned. 

KNOWLEDGE, SKILLS & ABILITIES:

• Work requires strong organizational skills.
• Work requires the ability to understand written medical and billing documentation.
• Work requires excellent knowledge of private and federal payment rules.
• Work requires a demonstrated ability to communicate effectively with various levels of constituents, patients and/or family, clinical staff, third party payers, management and other professionals outside the healthcare system.
• Work requires strong oral and written communication skills, including the use of medical terminology.
• Work requires working knowledge of Excel and word processing software in a Windows environment 

WORKING CONDITIONS:

Work is performed primarily in office area.

SECURITY:

This position is security-sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information. UT Southwestern Medical Center is committed to an educational and working environment that provides equal opportunity to all members of the University community. As an equal opportunity employer, UT Southwestern prohibits unlawful discrimination, including discrimination on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, gender expression, age, disability, genetic information, citizenship status, or veteran status. To learn more, please visit:

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