Consultant Provider Relations / Sterling Heights, MI

Details: Additional Job Information Title: Consultant Provider Relations City, State: STERLING HEIGHTS, MI Location: SMHMI 34204 VAN DYKE Department: SO SmartHealth Admin Additional Job Details: FT, Days Ascension Health ( www.ascension.org ) is a Catholic healthcare organization dedicated to the transformation of healthcare through excellent clinical care throughout the continuum of care and through innovation. Ascension is the nation’s largest Catholic and non-profit health system, providing the highest quality care to all with special attention to those who are poor and vulnerable. Last year Ascension provided $1.8 billion in care of persons living in poverty and community benefit programs. Its Mission-focused Health Ministries employ more than 150,000 associates serving in more than 1,900 sites of care in 23 states and the District of Columbia. Ascension’s direct subsidiaries provide services that include healthcare delivery, medical equipment management, treasury management, resource and supply management, venture capital investing, physician practice management, and risk management. Summary: The Consultant Provider Relations oversees the completion, submission and maintenance of provider enrollment for facilities and physician subsidiaries seeking government reimbursement. Responsibilities: Completes and submits provider enrollment initial applications, updates and revalidations for all facilities and physician subsidiaries seeking government reimbursement. Coordinates reviews of provider applications by appropriate departments. Develops and implements business solutions and procedures to prevent and mitigate issues and risks related to provider enrollment reporting requirements and record keeping. Develops and maintains systematic reporting processes with key administrative and clinical management positions in each facility and physician group to collect and report relevant data required for government provider enrollments, updates and revalidations. Resolves issues related to enrollments and updates as identified by fiscal intermediaries and/or government agencies and responds to related requests for information in a timely manner to prevent or minimized unforeseen cash flow interruptions of government reimbursements. Develops and maintains a master data file for all documentation relating to the filing of all government provider enrollments necessary to maintain billing compliance. Coordinates Provider Relations activities to ensure provider satisfaction through provider education, training, problem resolution and other provider relations activities. Assists in the contracting and setting of fee schedules for provider networks across Ascension as well as maintains the online provider manual and directory. Responsible for maintaining the web content for the SmartHealth web site. Coordinates Provider Relations communication of critical information to providers, including financial models, contractual terms and obligations and plan updates through email blasts, web site updates and other communications; responsible for verification, proofing and overall quality of Provider Relations communications. Education & Experience: Bachelor's Level Degree required. Five years of experience is required to include the following: three years completing government provider enrollment applications for hospital and/or physician practice two years in healthcare or insurance industry involving medical or health claims operations. Strong background in fee schedule development preferred Experience with EXCEL highly desired Equal Employment Opportunity Ascension Health is an EEO/AA employer: M/F/Disabled/Vet. For further information regarding your EEO rights, click on the following link to the “EEO is the Law” poster: http://ift.tt/1oONeAT ” E-Verify Ascension Health participates in the Electronic Employment Verification Program. Please click the E-Verify link below for more information. E -Verify (link to E-verify site)
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