Provider Enrollment Specialist

SHIFT:
Day (United States of America)

Seeking Breakthrough Makers

Children's Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will inspire you to pursue passions, develop expertise, and drive innovation.

At CHOP, your experience is valued; your voice is heard; and your contributions make a difference for patients and families. Join us as we build on our promise to advance pediatric care-and your career.

CHOP does not discriminate on the basis of race, color, sex, national origin, religion, or any other legally protected categories in any employment, training, or vendor decisions or programs. CHOP recognizes the critical importance of a workforce rich in varied backgrounds and experiences and engages in ongoing efforts to achieve that through equally varied and non-discriminatory means.

A Brief Overview

Provider Enrollment Specialist

Ready to own the provider enrollment process and make a real difference? As our go-to expert, you'll lead critical projects, solve complex challenges, and drive faster provider onboarding by uncovering trends and breaking down barriers. Collaborate cross-functionally, manage priorities like a pro, and champion process improvements-all while ensuring compliance. If you're a problem-solver who thrives on impact and speed, this role was made for you!

Join a close-knit team of five dedicated professionals supporting CHOP's Revenue Cycle team. As a Provider Enrollment Specialist, you'll play a key role in processing pre-enrollment for providers across our Behavioral Health department and other specialty areas.

This role is hybrid requiring one onsite day (Wednesday) weekly. Onsite presence for trainings or other meetings may be required. The Provider Enrollment Specialist will work a consistent schedule starting their day between 7am-9am and end by 3:30pm-5pm.

Ideal Candidate:

We're looking for someone who thrives in both independent and team settings, pays close attention to detail, and brings strong billing knowledge to the table. In this role, you'll regularly communicate with providers and organizational leadership, so clear and confident communication is essential.

Experience with CAQH, ECHO, and payor portals is highly valued and will help you succeed in this position. If you enjoy a collaborative environment and are passionate about supporting a mission-driven healthcare organization, we'd love to hear from you!

What you will do

• Acts as subject matter expert in their department, manages projects to timely completion, troubleshoots issues and maintains accurate and compliant workflows.
• Holds inter-departmental relationships within PFS and outside of PFS; manages assigned workflows and work queues associated with these relationships and is the primary communicator with the department for any improvement opportunities.
• Monitors work queues assigned as their responsibility, meeting established production and quality standards for the assigned tasks.
• Specific focus is project oriented. Identify trends, training opportunities, denial prevention initiatives and maintaining internal controls for the department.
• Performs workflow analysis, documents workflows, and testing planning in support of departments strategic and operational objectives.
• Stays current on regulations and industry standard trends to ensure CHOP is compliant.
• Responsible for creating presentation and data analytics to drive change and improvements.
• Documents processes to help keep revenue cycle stakeholders informed and identify optimization opportunities.
• Other duties as assigned.

Education Qualifications

• High School Diploma / GED Required
• Bachelor's Degree Preferred

Experience Qualifications

• At least three (3) years of work experience in healthcare billing or collections environment or other related role. Required
• Demonstrated success in resolution of patient accounts; demonstrated ability to identify trends and complete assignments timely Required
• At least one (1) year of coding experience Preferred

Skills and Abilities

• Strong math aptitude (Required proficiency)
• Excellent organizational skills. (Required proficiency)
• Clear and concise decision making skills (Required proficiency)
• Leadership skills (Required proficiency)
• Detail oriented (Required proficiency)
• String interpersonal skills (Required proficiency)
• Excellent writing and oral communication skills (Required proficiency)
• Ability to work independently; results oriented (Required proficiency)
• Ability to handle confidential matters. (Required proficiency)
• Flexibility to work overtime as needed/required (Required proficiency)
• Experience with personal computers including Excel (Required proficiency)
• Experience with Epic system (Preferred proficiency)

To carry out its mission, CHOP is committed to supporting the health of our patients, families, workforce, and global community. As a condition of employment, CHOP employees who work in patient care buildings or who have patient facing responsibilities must receive an annual influenza vaccine. Learn more.

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SALARY RANGE:

$30.25 - $38.55 Hourly

Salary ranges are shown for full-time jobs. If you're working part-time, your pay will be adjusted accordingly.

At CHOP, we are committed to fair and transparent pay practices. Factors such as skills and experience could result in an offer above the salary range noted in this job posting. Click here for more information regarding CHOP's Compensation and Benefits.