Provider Enrollment Operations Manager

Palmetto GBA, LLC; Columbia (SC); On-site; USD 75,000 - 95,000; Full time

Benefits offered by this job

Health insurance

401k plan with company match

Life Insurance

Paid Time Off (PTO)

On-site cafeterias and fitness centers

Education assistance

Service recognition

National discounts

Job summary

Palmetto GBA, LLC, located in Columbia, SC, seeks a Provider Enrollment Unit Manager to oversee enrollment staff and ensure timely processing of provider enrollments and related claims. The role emphasizes regulatory compliance, fraud awareness, and performance management within a 40-hour work week onsite.

The position requires a Bachelor's degree, 5 years in healthcare/Medicare operations, and at least 2 years in a leadership role, with strong communication, analytical, and organizational

Qualifications

• A Bachelor's degree in a job-related field is required.
• 5 years of healthcare, Medicare, health insurance operations, or operations experience; 2 years of leadership experience (may be concurrent with the 5 years).
• Excellent verbal and written communication, organizational, and customer service skills.
• Proficiency in spelling, grammar, and punctuation; ability to persuade, negotiate, or influence others.

Responsibilities

• Provides day-to-day management oversight of enrollment staff ensuring accurate and timely completion of provider enrollment and claims administration.
• Manages unit performance to meet productivity, quality, and timeliness standards.
• Ensures compliance with applicable laws and regulations and tracks new requirements.
• Directs analysts to identify potential fraud and pursue investigations.
• Interacts with management to define goals, objectives and performance measures.
• Maintains quality assurance activities and analyzes reports to identify improvement opportunities.
• Collaborates with other departments to implement process and system improvements.
• Prepares and verifies reports as necessary.

Skills

Communication

Organization

Customer service

Presentation

Analytical thinking

Critical thinking

Problem solving

Judgment

Listening

Education

Bachelor's degree

Tools

Microsoft Office

Job description

Palmetto GBA, LLC, located in Columbia, SC, seeks a Provider Enrollment Unit Manager to oversee enrollment staff and ensure timely processing of provider enrollments and related claims. The role emphasizes regulatory compliance, fraud awareness, and performance management within a 40-hour work week onsite.

The position requires a Bachelor's degree, 5 years in healthcare/Medicare operations, and at least 2 years in a leadership role, with strong communication, analytical, and organizational