To apply for this opportunity, please use the link at the bottom of the job description.
Who Are We?
MedAmerica is a physician practice management company providing business and clinical consulting services to several clients, including one of the premier emergency medicine and hospitalist groups in the nation.
What We Are Searching For:
This exciting opportunity is responsible for managing our enterprise-wide enrollment for all government payers and other managed care plans contributing to the goal of optimizing reimbursement to our healthcare providers. This person will interpret complex payer regulations, but also love overseeing a number of details. The ideal candidate will appreciate a dynamic environment that may include enrollment for new contracts, evaluating trends, troubleshooting payer issues, and maintaining a high level of communication to both internal teams and our client leadership. Finally, this person will rally a team to maintain high productivity and quality standards.
Here’s How You Would Support MedAmerica and our Clients:
- Troubleshoot and oversee resolution of provider enrollment issues and consult when necessary with clients and MA Management and Governance regarding these issues.
- Generate and present ideas to improve departmental protocols.
- Monitor productivity and quality of provider enrollment applications and submissions.
- Ensure timeliness and quality of provider enrollment are in compliance with payer expectations for reimbursement.
- Interface with client Billing Agents, and Reimbursement workgroup to provide support with contracting requests and issues, and updates regarding provider enrollment status.
- Interface with Quality Improvement personnel regarding requirements for managed care audits.
- Maintain high level of expertise regarding Federal and multi-State policies that may adversely affect the provider enrollment process thus impacting our client’s revenue.
- 2-3 years working with government payers, physicians, and direct provider enrollment experience required. Managed care or billing background preferred. College degree required.
- 1-2 years management experience with supervising a department with multiple staff members.
- Excellent writing and presentation skills. Superb communication skills.
- Good organizational and project management ability.
- Ability to review managed care contracts and interpret payer regulations.
- Successfully able to navigate payer issues and facilitate issue resolution.
- High level of discernment, autonomy, and independent decision-making.
- Ability to understand business structures and how this impacts provider enrollment.
- Responsible for reviewing licensing, payer enrollment and regulations for new contracts.
- Proven ability to communicate with executives.
- Ability to identify opportunities for automation and using systems to integrate processes.
Why Work with MedAmerica?
- Voted a “Best Place to Work in the Bay Area” seven years in a row
- Located in Emeryville overlooking the San Francisco Bay
- Offers a friendly, stimulating, and business casual work atmosphere
- Competitive benefits package: including complimentary fitness center, dependent care plan, medical flexible spending account, 401k program (including a very generous company match), medical, dental, vision, prescription, long term disability, and life insurance just to name a few.
MedAmerica is an Equal Opportunity Employer.