Description:

Description

• Candidate should possess extensive knowledge of Medicaid enrollment structure and process in multiple states, including familiarity with enrollment management systems to streamline operations.
• Experience in group & individual Medicaid enrollment.
• Knowledge of applicable state and federal laws, regulations and requirements related to Medicaid.
• Proficiency in analyzing enrollment data to identify trends, ensure accuracy, and improve processes.
• Ability to prepare and/or update a provider’s CAQH application, where applicable.
• The ability to build and maintain peer-to-peer relationships with all internal and external business partners at all levels.
• Establish credentialed statuses to facilitate billing.
• Maintain and update credentialing, billing, and other internal databases completely and accurately which must include, but is not limited to, status updates, follow up timelines, and revenue risk associated with potential delays.
• Ability to identify and communicate risk while maintaining and adhering to proper escalation procedures.
• In-depth working knowledge of the various applications associated by plan as well as internally and the workflow process defined by department leadership.
• Ensure all workflow items are completed within the set turn-around-times, meeting deadlines, while maintaining high levels of accuracy and quality.

2503002947 Minimum Qualifications Full Time

Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status.

Tenet participates in the E-Verify and Work Opportunity Tax Credit (WOTC) programs. Follow the links below for additional information.

E-Verify: http://www.uscis.gov/e-verify
WOTC: https://www.doleta.gov/business/incentives/opptax