***May be Available for Hybrid Work***

 

OHSU is Oregon’s only public academic health center. We are a system of hospitals and clinics across Oregon and southwest Washington. We are an institution of higher learning, with schools of medicine, nursing, pharmacy, dentistry and public health – and with a network of campuses and partners throughout Oregon. We are a national research hub, with thousands of scientists developing lifesaving therapies and deeper understanding. We are a statewide economic engine and Portland’s largest employer. And as a public organization, we provide services for the most vulnerable Oregonians, and outreach to improve health in communities across the state.

 

The Enrollment Coordinator is responsible for enrolling OHSU Practice Plan practitioners, OHSU affiliated

practitioners, OHSU facilities, and OHSU Partners’ facilities with government and insurance carriers; and is

responsible to initiate and maintain active billing status in accordance with organizational policies and

procedures, regulatory requirements and contracts for governmental and commercial payers, and Medical Staff

Bylaws.

Enrollment Process

• Utilize Health Information Systems to analyze and investigate practitioner information, and distribute provider credentialing and enrollment packets in coordination with OHSU Medical Affairs Program, meeting established policies and procedures. Prepare and distribute practitioner and facility data, complying with the requirements outlined by state government, federal government, and commercial carriers. Perform data entry of sensitive provider information in federal and state provider enrollment systems. This process requires knowledge of legal, federal, state, and OHSU requirements; the National Plan and Provider Enumeration System (NPPES); the Medicaid Management Information System (MMIS); licensing boards; MSOW; the Oregon Practitioner Credentialing Application (OPCA); the Provider Enrollment Chain and Ownership System (PECOS); the CMS Identity and Access Management System; and, Washington’s ProviderOne. Collaborate with OHSU Medical Affairs Program, OHSU departments and OHSU Partners to achieve accurate credentialing, timely enrollment, and compliant billing status. Troubleshoot problem claims in EPIC work queues. Maintain positive relations with insurance carriers to assist with timely reimbursement, problem solving, and plan participation. Perform timely annual enrollment and termination of residents and fellows.

File Maintenance

• Collect and maintain appropriate provider documentation and licensure, perform manual enrollment processes, and facilitate practitioner payer re-credentialing and revalidations. Update and maintain practitioner and facility database as a central resource for OHSU, OHSU Health Plan and OHSU partners, including department and billing personnel. Document, maintain and understand regulatory requirements for governmental and commercial payers.

Audits and Special Projects

• Develop and update necessary workflows and documentation relevant to provider enrollment to improve effectiveness of department operations. Provide ad hoc reporting based on need or request. Participate in special claims correction projects related to enrollment. Promote and implement LEAN processes. Perform other duties as assigned.

• High School Diploma or equivalent required AND 
• 2 years in health care, medical billing and/or insurance environment. Experience with provider enrollment or insurance credentialing, including knowledge of governmental and commercial insurance and HIPAA regulations, and understanding of managed care contract policies in a health care or insurance carrier setting required; OR 
• Associates Degree and 1 years’ experience health care and/or health insurance; OR
• A combination of education and experience. 

Job Related Knowledge, Skills and Abilities:

• Demonstrated software database experience (for efficient generation of letters and other correspondence, activity tracking and report production).
• Demonstrated ability to work with a diverse team and customer base, using excellent communication skills, listening, verbal, and written.
• Strong organizational skills, accurate data entry, and the ability to multi-task. 
• Proficiency with standard office equipment and software such as Microsoft Office. 
• Knowledge of health care information systems.
• Familiarity with legal, state, and health care insurance guidelines, assuring compliance with regulatory agencies.

Work Location: Work from Home/FAB 5th Floor

Work Schedule: Monday-Friday 7:30am-4:30pm

 

Benefits:

• Two raises per year – One at anniversary date and one across the board annual increase
  
• Healthcare Options - Covered 100% for full-time employees and 88% for dependents, and $25K of term life insurance provided at no cost to the employee
  
• Two separate above market pension plans to choose from
  
• Vacation- up to 200 hours per year depending on length of service
  
• Sick Leave- up to 96 hours per year
  
• 8 paid holidays per year
  
• Substantial Tri-met and C-Tran discounts
  
• Additional Programs including: Tuition Reimbursement and Employee Assistance Program (EAP)
  

Oregon Health & Science University values a diverse and culturally competent workforce. We are proud of our commitment to being an equal opportunity, affirmative action organization that does not discriminate against applicants on the basis of any protected class status, including disability status and protected veteran status. Individuals with diverse backgrounds and those who promote diversity and a culture of inclusion are encouraged to apply. To request reasonable accommodation contact the Affirmative Action and Equal Opportunity Department at 503-494-5148 or aaeo@ohsu.edu.