Business Process Delivery

MMC Group

Austin, TX
28 days ago

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Skills

Ambulance Servicesunmatched
Analysis Skillsunmatched
Business Administrationunmatched
Business Operationsunmatched
Business Processesunmatched
Communication Skillsunmatched
Computer Skillsunmatched
Customer Support/Serviceunmatched
Data Entryunmatched
Establish Prioritiesunmatched
File Maintenanceunmatched
HIPAA (Health Insurance Portability and Accountability Act)unmatched
Healthcareunmatched
Healthcare Administrationunmatched
High School Diplomaunmatched
High Tech Industryunmatched
Interpersonal Skillsunmatched
Leadershipunmatched
Medicaidunmatched
Microsoft Officeunmatched
Multitaskingunmatched
Nursingunmatched
Organizational Skillsunmatched
Presentation/Verbal Skillsunmatched
Problem Solving Skillsunmatched
Process Improvementunmatched
Provider Credentialingunmatched
Public/Media/Press/Analyst Relationsunmatched
Quality Assuranceunmatched
Quality Monitoringunmatched
Team Playerunmatched
Technical/Engineering Designunmatched
Time Managementunmatched
Transaction Processing/Managementunmatched
Writing Skillsunmatched

Description

Business Process Delivery professionals execute repeatable core business processes and/or technical transactions with a focus on efficiency, first-time quality and overall continuous process improvement.

Job Description

The job duties for the Provider Enrollment Business Analyst are as follows:

Interact professionally with providers and ancillary staff to provide appropriate and timely response to inquiries and concerns regarding provider enrollment and file maintenance for Medicaid programs (including dental, vision, ambulance, physicians, nurses and all other provider types)
Process to completion 100% of assigned applications utilizing documented work instructions, daily and meet minimum daily quotas
Provider outreach and assistance in completing electronic enrollment applications unacceptable to the system
Data entry (of paper applications) with validation of provider submitted enrollment information to insure the enrollment application meets the minimum standards
Respond to inquiries regarding status of applications received
Research and contact providers to resolve enrollment application deficiencies
Perform liaison role between business operation departments and IT from project initiation to post implementation on responsibilities include the overall planning, organizing, directing, controlling and delivery of all projects prioritized in alignment with the customers expectations and business needs. communicating changes in scope, requirements and/or functional design with departmental leadership. developing recommended solutions in consultation with departmental leadership.
Adhere to Quality Assurance program in order to improve daily processing of applications and file maintenance transactions with a minimum quality score of 98%
Monitor and Review Quality Assurance results in order to improve daily processing of applications and file maintenance transactions
Makes recommendations to management to improve efficiency/effectiveness of current manual processes through systemic modifications
Maintain strict confidentiality of information and job files as dictated by current HIPAA requirements
Respond to Tier III escalations and/or file maintenance requests as assigned within the specified due dates
Flexibility to work overtime as dictated by daily production inventory requirements
Perform other duties as assigned by leadership

Basic Qualifications:

Bachelors Degree in Business Administration or Healthcare Administration or related disciplines or High School Diploma and 1 additional years of work experience in Health Care related industry.
Minimum of one year of experiencein the enrollment credentialing of healthcare providers

Preferred:

Minimum 1years experience in customer service, public relations, education or related field - Personal Computer experience (Microsoft Office Suite)
Proven ability to work independently and as a team member
Good communication (written and oral) and interpersonal skills
Good organizational, multi-tasking, and time-management skills

Professional Skill Requirements

Eagerness to contribute in a team-oriented environment
Ability to work creatively and analytically

Numbers & Facts

Location

Austin, TX

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