Enrollment & Billing Director jobs in Ann Arbor, MI

Enrollment & Billing Director oversees one or more departments responsible for enrollment and billing operations for an insurance company. Ensures information accuracy and customer satisfaction. Being an Enrollment & Billing Director establishes and implements organizational policies. May offer guidance on appropriate handling of complex or high-value accounts. Additionally, Enrollment & Billing Director typically requires a bachelor's degree. Typically reports to top management. The Enrollment & Billing Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. To be an Enrollment & Billing Director typically requires 5+ years of managerial experience. (Copyright 2024 Salary.com)

I
Provider enrollment
  • IHA
  • Ann Arbor, MI FULL_TIME
  • POSITION DESCRIPTION :

    In collaboration with the Provider Credentialing Manager, directs the work of the Provider Enrollment Team to ensure timely completion of all IHA provider enrollment and credentialing.

    Oversees daily program operations and coordinates processes necessary to provide credentialing / re-credentialing documentation, reports and other information and to ensure compliance with credentialing (payer, hospital and IHA) policies and procedures and maintenance of the provider database (CredentialStream).

    The Provider Enrollment Specialist III will maintain responsibility for all aspects of the enrollment, credentialing, re-credentialing process for all providers.

    Responsible for ensuring providers are credentialed, appointed, and privileged with health plans and hospitals.

    SENIOR SPECIALIST ESSENTIAL JOB FUNCTIONS :

    Provides guidance and support for the Provider Enrollment Specialist Team, ongoing training regarding credentialing process, payer requirements and hospital privilege requirements.

    Serves as a subject matter expert for the team, provides direction and problem-solves on complex or unusual credentialing issues.

    • Subject Matter Expert in CredentialStream and generating reports, collaborative agreements, provider hold reports and RPA Bot initiatives.
    • Ensures the maintenance of information with new / updated software for provider credentialing; researches, develops, implements and oversees the maintenance of a robust IHA Provider Database for multiuse purposes to include licensure, professional liability records and insurance plan credentialing.
    • Along with Provider Credentialing Manager, provides direction and training to the credentialing team to ensure the maintenance of information with new / updated software for provider credentialing.
    • Assists Provider Credentialing Manager with requests, questions and concerns from cross-functional departments, such as the Revenue Applications department.
    • Assists Manager to address and resolve all relevant provider questions / concerns related to credentialing and enrollment.
    • Works to ensure enrollment team is meeting start dates and working to improve inefficiencies.
    • Serve as backup to provider enrollment specialists, which includes maintaining and enrolling / credentialing new providers, as needed.

    Will MAINTAIN THE FOLLOWING ESSENTIAL JOB FUNCTIONS :

    • Compiles and maintains current and accurate data for all providers.
    • Maintains copies of current state licenses, DEA certificates, board certifications and any other required credentialing documents for all providers.
    • Maintains knowledge of current health plan and hospital requirements for credentialing providers.
    • Sets up and maintains provider information in online credentialing databases and systems.
    • Tracks licenses and certification expirations for all providers to ensure timely renewals.
    • Performs new facility credentialing processes with all new mergers.
    • Provides support to Central Billing Office regarding provider effective dates / provider numbers and keeps appropriate IHA personnel informed as to the status of credentialing of new providers.
    • Prepares, submits, and follows up on credentialing and enrollment applications and ensures that supporting documentation is collected and provided to plans / hospitals as needed in a timely manner.
    • Establishes and maintains provider files to include necessary documentation and understands the plan requirements for credentialing a provider with all of insurance carriers we currently participate with for all types of providers.
    • Follows up on the status of applications and provider licenses and facilitates the renewal process; tracks the progress on all pending applications and works to resolve issues as they arise.
    • Assists with maintenance of Insurance Participation list by keeping provider numbers current, updating insurance information.
    • Ensures signed applications are received from providers as well as they are being sent to the plans and is aware of carrier timelines / committee approval schedules.

    Performs CAQH updates and maintenance.

    • Coordinates the National Provider Identifier application for all new hire providers / offices and updates existing physicians’ information.
    • Sends Practice Managers a credentialing status spreadsheet before a new provider starts, updating on a weekly basis.
    • Brings areas of concern and recommendations to Provider Credentialing Manager.
    • Maintains familiarity with CBO policies and procedures.
    • Supports special project work, as needed.
    • Assumes additional duties, as required.

    ORGANIZATIONAL EXPECTATIONS :

    • Creates a positive, professional, service-oriented work environment for staff, patients and family members by supporting the mission and values of both IHA and Trinity Health.
    • Must be able to work effectively as a member of the Provider Enrollment / Credentialing team.
    • Assumes responsibility for performance of job duties in the safest possible manner, to assure personal safety and that of coworkers, and to report all preventable hazards and unsafe practices immediately to management.
    • Successfully completes IHA’s The Customer training and adheres to IHA’s standard of promptly providing a high level of service and respect to internal or external customers.
    • Maintains knowledge of and complies with IHA standards, policies and procedures.
    • Maintains knowledge of IHA office services and in the use of all relevant office equipment, computer and manual systems.
    • Maintains strict patient and employee confidentiality in compliance with IHA and HIPAA guidelines.
    • Serves as a role model by demonstrating exceptional ability and willingness to take on new and additional responsibilities.

    Embraces new ideas and respects cultural differences.

    • Uses resources efficiently.
    • Responsible for ongoing professional development maintains appropriate licensure / certification and continuing education credentials, participates in available learning opportunities.

    MEASURED BY :

    Performance that meets or exceeds IHA CARES Values expectation as outlined in IHA Performance Review document, relative to position.

    ESSENTIAL QUALIFICATIONS :

    EDUCATION : Associates degree or equivalent combination of education and experience in a relevant field (five or more years).

    CREDENTIALS / LICENSURE : N / A

    MINIMUM EXPERIENCE : Minimum of three years of experience in the field or in a related area, with extensive understanding of provider credentialing requirements.

    POSITION REQUIREMENTS (ABILITIES & SKILLS) :

    • Maintains extensive knowledge of physician and mid-level provider credentialing requirements, processes; serves as subject matter expert and provides guidance on complex or unusual credentialing issues.
    • General knowledge of legal requirements and reporting regulations affecting human resources-related functions that potentially affect physicians and mid-level providers.
    • Demonstrated experience utilizing IHA’s payroll, credentialing tools and systems as well as other specific provider credentialing software or other tools as implemented.
    • Proficient in operating a standard desktop and Windows-based computer system, including but not limited to, payroll software, Microsoft Word and Excel, intranet and computer navigation.

    Ability to use other software as required while performing the essential functions of the job.

    • Ability to delegate tasks as appropriate and ensure follow-up as needed.
    • Excellent communication skills in both written and verbal forms, including proper phone etiquette. Ability to speak before groups of people (both in-person and virtually) for training purposes.
    • Ability to work collaboratively in a team-oriented environment; displays courteous, professional and friendly demeanor.
    • Ability to work effectively with various levels of organizational members and diverse populations.
    • Ability to cross-train in other areas of the department in order to achieve smooth flow of all operations.
    • Good organizational and time management skills to effectively juggle multiple priorities and time constraints in a fast-paced environment.
    • Ability to exercise sound judgment and problem-solving skills, specifically as it relates to resolving provider enrollment and credentialing issues.
    • Ability to handle IHA provider, payroll and organizational information in a confidential manner.
    • Successful completion of IHA competency-based program within introductory and training period.
    • Last updated : 2024-02-23

  • 1 Month Ago

A
Student Enrollment & Records Specialist
  • Ann Arbor Public Schools
  • Ann Arbor, MI FULL_TIME
  • JobID: 14131 Position Type: Secretarial/Clerical Date Posted: 8/25/2022 Location: Balas Administration Building Closing Date: 09/06/2022 District: Ann Arbor Public Schools - website POSITION TITLE: St...
  • 13 Days Ago

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Provider Enrollment Support
  • Coronis Health
  • Jackson, MI FULL_TIME
  • Job title Provider Enrollment Support Classification Hourly, Non Exempt Salary: $15-$16 per hour* Starting pay varies based on location and experience, in compliance with specific state wage regulatio...
  • 16 Days Ago

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Billing assistant
  • Hired in Michigan
  • Wixom, MI FULL_TIME
  • Basic math skills and attention to detail required. Part-time or full-time positions available. Training provided. Last updated : 2024-03-02
  • 23 Days Ago

A
Billing associate
  • Avfuel Corporation
  • Ann Arbor, MI FULL_TIME
  • Employment Type : Full Time, Onsite Location : Ann Arbor, MI; Corporate Office Environment Benefits : Medical, Dental, Vision, Paid Vacation, Sick & Holidays; Company paid Life and Disability Insuranc...
  • 1 Day Ago

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Billing Clerk
  • Randy Wise Buick GMC
  • Fenton, MI FULL_TIME
  • At Randy Wise Auto Group, we strive to make every customer a customer for life. Happy employees make happy customers, and we reward individuals who are ready to work hard and stay motivated. Every emp...
  • 4 Days Ago

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0 Enrollment & Billing Director jobs found in Ann Arbor, MI area

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Managing Director, Utilities Customer Programs & Experience
  • Black & Veatch
  • Ann Arbor, MI
  • **Managing Director, Utilities Customer Programs & Experience** Date: Mar 1, 2024 Location: US Company: Black & Veatch F...
  • 3/29/2024 12:00:00 AM

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Mental Health Therapist - Remote
  • WellQor Management Services, Inc
  • Ann Arbor, MI
  • Job Description About WellQor: WellQor is a patient centered, full-service psychological practice accessible online. We ...
  • 3/29/2024 12:00:00 AM

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Sr. Revenue Integrity Analyst Full Time Hybrid
  • Henry Ford Health System
  • Troy, MI
  • GENERAL SUMMARY: Reporting to the Manager, Revenue Integrity, Revenue Integrity Senior Analyst has an important role in ...
  • 3/28/2024 12:00:00 AM

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Event Support Specialist
  • Michigan
  • Ann Arbor, MI
  • **Event Support Specialist** **How to Apply** A cover letter is required for consideration for this position and should ...
  • 3/28/2024 12:00:00 AM

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Corporate Program Finance Controller
  • AUTOKINITON
  • Romulus, MI
  • AUTOKINITON is a Michigan-based family of automotive companies delivering operational excellence, high-quality execution...
  • 3/27/2024 12:00:00 AM

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Director of Treasury
  • Presbyterian Villages of Michigan
  • Southfield, MI
  • Overview: Presbyterian Villages of Michigan, a premier senior living and services faith-based non-profit organization, i...
  • 3/27/2024 12:00:00 AM

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Dental Operations Team Member
  • Ann Arbor Smiles
  • Ann Arbor, MI
  • Job Description Job Description Company Overview: At Ann Arbor Smiles Dental Group, our mission is to improve the lives ...
  • 3/27/2024 12:00:00 AM

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Financial Aid Specialist
  • Henry Ford College, MI
  • Dearborn, MI
  • Salary: $51,226.00 - $60,214.00 Annually Location : Dearborn, MI Job Type: Full-Time Job Number: 202200255 Division: Fin...
  • 3/25/2024 12:00:00 AM

Ann Arbor is a city in the U.S. state of Michigan and the county seat of Washtenaw County. The 2010 census recorded its population to be 113,934, making it the sixth largest city in Michigan. Ann Arbor is home to the University of Michigan. The university significantly shapes Ann Arbor's economy as it employs about 30,000 workers, including about 12,000 in the medical center. The city's economy is also centered on high technology, with several companies drawn to the area by the university's research and development infrastructure. Ann Arbor was founded in 1824, named for wives of the village'...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Enrollment & Billing Director jobs
$146,272 to $213,025
Ann Arbor, Michigan area prices
were up 1.3% from a year ago

Enrollment & Billing Director in Florence, SC
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Enrollment & Billing Director in Medford, OR
The center staff will try to accommodate the enrollment needs of parents, but because of being a university based center, there is no guarantee that spaces will be available at the exact time to meet the needs of parents.
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Enrollment & Billing Director in New Haven, CT
A minimum of 7 years managing direct customer support operations, with membership related duties inclusive of enrollment, billings and reconciliations preferred.
January 18, 2020