Provider Enrollment Compliance - Coordinator 1

University of New Orleans; Baton Rouge (LA); On-site; USD 42,000 - 52,000; Full time

Job summary

LSU New Orleans is seeking a Provider Enrollment Compliance Coordinator responsible for monitoring the PE Unit, ensuring enrollment of 65,000+ providers and ongoing compliance with federal and state regulations. The role interfaces with multiple agencies and facilities to implement enrollment eligibility for complex provider types.

You will help develop policy changes, participate in workshops, and support ACA-related procedures while acting as a liaison to LDH management and internal teams.

Qualifications

• Bachelor’s degree required; associates with 3 years of experience or 6 years in lieu of degree.
• Advanced degree preferred.
• Experience in healthcare compliance auditing, provider enrollment, or credentialing is desirable.

Responsibilities

• Monitor Provider Enrollment (PE) Unit activities and enrollment of 65,000+ providers.
• Interface with bureaus, contractors, and teaching facilities to implement eligibility for complex provider types.
• Recommend criteria for closing inactive files and maintaining compliance with regulations.
• Coordinate policy changes and participate in provider workshops and training.
• Assist with ACA compliance, enrollment applications, forms, and manuals revisions.
• Serve as Provider Enrollment Subject Matter Expert and liaise with LDH management.

Skills

Analytical skills

Time management

Attention to detail

Project management

Microsoft Office

Education

Bachelor's degree

Associates degree with 3 years experience

Advanced degree

Tools

Outlook

Word

Excel

Job description

Provider Enrollment Compliance - Coordinator 1### Provider Enrollment Compliance - Coordinator 1Apply: Baton Rouge, La: Full time: Posted Today: R-002214Thank you for your interest in LSU New Orleans. Once you start the application process, you will not be able to save your work, so you should collect all required information before you begin. The required information is listed below in the job posting. You must complete all required portions of the application and attach the required documents in order to be considered for employment.**Department**Design and Covered Services## ## **Job Summary**## ## **Job Description*** Monitors the activities of the Provider Enrollment (PE) Unit of the Fiscal Intermediary (FI) and responsible for the monitoring the enrollment and maintenance of over 100 provider types inclusive of over 65,000 providers.* Monitors activities of the Medicaid Provider Subsystem to ensure continued compliance with federal and state regulations, legislative or independent audit findings.* Recommends criteria for implementing activities for the closure and removal (nonparticipating or no activity in eighteen months) of inactive files on the MMIS provider subsystem.* Interfaces with agency bureaus/offices, contractors (such as Office of Behavioral Health, Health Standards, and Managed Care Organizations) as well as state teaching facilities to implement eligibility of certain provider types whose enrollment requirements are more complex and require extended time.* Monitors current and proposed state and federal regulations and clarifications for Impact on present program/system functions.* Meets and/or communicates with federal regulatory agencies, fiscal intermediary staff, providers, and program staff on program/system changes, enhancements and integrity.* Attends meetings to coordinate implementation of policy changes which affect providers.* Participates in strategy development with the fiscal intermediary to formulate and implement such changes.* Assist and participate with the development and implementation of the new Provider Management Project. Serve as the Provider Enrollment “Subject Matter Expert”.* Monitor and assist the Fiscal Intermediary with the day-to-day operation of PE.* Act as liaison between LDH staff and the Fl for design changes, ECHOS, issues with file and/or form discrepancies and special request as it arises.* Consult with and keep LDH management abreast of new developments, major changes and or issues.* Consult with internal staff and external agencies regarding Provider Enrollment issues. Assist with procedures to maintain PE compliance with the Affordable Care Act (ACA) mandates.* Coordinate, participate, review and approve the revisions made to the enrollment applications, forms, and manual.* Research, develop and/or direct small Medicaid projects as assigned.* Assist the Program Integrity staff regarding the enrollment files, for compliance purposes.* Assist Program staff with the creation of new provider types and packets.* Participate in provider workshops, seminars and or training, as requested.* Monitor the PE stats produced by the Fl.* Monitor the Fl for compliance regarding their contractual obligations.* Other duties as assigned. **QUALIFICATIONS** **REQUIRED:*** Bachelor’s Degree, or Associates degree with 3 years professional experience, or 6 years professional experience in lieu of the degree.* Excellent analytical skills, effective organizational and time management skills.* Great attention to detail and follow up.* Ability to manage projects, assignments, and competing priorities.* Proficient in the use of Microsoft Office, including but not limited to Outlook, Word, and Excel.**DESIRED:*** Advanced Degree.* Minimum 1 year professional experience in healthcare compliance auditing, provider enrollment, or credentialing.* Minimum 1 year professional experience working with Medicaid program support.* Minimum 1 year professional experience with claims processing and billing.* CPT, ICD-9 or ICD10 coding and HCPCS knowledge. SALARY: 42-52k**Required Attachments** Please upload the following documents in the Resume/Cover Letter section.* Detailed resume listing relevant qualifications and experience;* Cover Letter indicating why you are a good fit for the position and LSU New Orleans;* Names and contact information of three references; Applications that do not include the required uploaded documents may not be considered.## Posting Close DateThis position will remain open until filled. Note to Applicant: Applicants should fully describe their qualifications and experience with specific reference to each of the minimum and preferred qualifications in their cover letter. The search committee will use this information during the initial review of application materials.References will be contacted at the appropriate phase of the recruitment process.This position may require a criminal background check to be conducted on the candidate(s) selected for hire.As part of the hiring process, applicants for positions at LSU New Orleans may be required to demonstrate the ability to perform job-related tasks. LSU New Orleans seeks to recruit a highly productive workforce and will provide equal employment opportunities to all employees and prospective employees. Employment decisions shall be based strictly on merit and without regard to religious or political beliefs, sex, race, or any other non-merit factor.