Provider Enrollment Specialist

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:,ActualValueFromSolar:null},{QuestionName:Job Summary,AnswerValue:JOB OVERVIEWu003cbr/u003eThe Provider Enrollment Specialist will report directly to the Pre Billing Manager. This position is responsible for coordinating, processing and tracking all new and existing billing UCSF providers (approximately 800) at ZSFG (Zuckerberg San Francisco General Hospital) that are appropriately enrolled into Medicare, Medi-Cal, contracted health plans, and other third party payers, and are required to receive appropriate payment for rendered services.The individual serves as the primary contact and resource for all ZSFG provider enrollment activities in accordance with the CPG Bylaws, JCAHO and ZSFG Medical Staff accreditation and credentialing standards. The individual must maintain accurate records for each provider at all times and deals regularly with complex policy and procedural issues that involve compliance with federal and state agencies such as the Center for Medicare and Medicaid Services (CMS) and Department of Health Care Services (DHCS).u003cbr/u003eu003cbr/u003eThe individual works and communicates directly with the providers, all levels of administrative staff at the departments at ZSFG, and ZSFG Medical Staff office. Collaborates with UCSF Office of Medical Affairs and Governance, interacts with outside agencies and fiscal intermediaries and serves as the primary point of contact for all internal and external inquiries regarding provider enrollment and eligibility.u003cbr/u003eu003cbr/u003eThis position involves a thorough knowledge of the complex aspects of the provider enrollment process. As the fiscal intermediaries are mandating more rules and regulations, it is necessary for this position to be updated and kept abreast of the changing needs within the healthcare delivery system. Reimbursement is directly tied to provider enrollment; therefore, it is imperative that this position be continuously educated and knowledgeable with third party billing guidelines and the changes/updates related to provider enrollment. With the ongoing compliance issues in the academic setting, it is equally important for this position to ensure utmost accuracy in the completion of the forms, timely submission and follow-up. u003cbr/u003eu003cbr/u003eCLINICAL PRACTICE GROUPu003cbr/u003eThe Clinical Practice Group (CPG) Business Services provides the University with an internal and centralized physicians’ professional fee billing operation at Zuckerberg San Francisco General Hospital. This includes all 20 ZSFG departments and five off-site clinics. The Business Office processes a total of 570,000 line charges per year consisting of $185M in billed charges.u003cbr/u003eu003cbr/u003eABOUT UCSF u003cbr/u003eThe University of California, San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It is the only campus in the 10-campus UC system dedicated exclusively to the health sciences.,VerityZone:jobdescription,QuestionType:textarea,ActualValueFromSolar:null},{QuestionName:Organization,AnswerValue:Campus,VerityZone:location,QuestionType:select,ActualValueFromSolar:null},{QuestionName:Req Number,AnswerValue:55753BR,VerityZone:autoreq,QuestionType:text,ActualValueFromSolar:null},{QuestionName:Location,AnswerValue:3130 20th Street San Francisco CA,VerityZone:formtext8,QuestionType:single-select,ActualValueFromSolar:null},{QuestionName:Job Title,AnswerValue:Provider Enrollment Specialist,VerityZone:formtext10,QuestionType:text,ActualValueFromSolar:null},{QuestionName:Appointment Type,AnswerValue:Career,VerityZone:formtext12,QuestionType:radio,ActualValueFromSolar:null},{QuestionName:Percentage,AnswerValue:100%,VerityZone:formtext13,QuestionType:Text,ActualValueFromSolar:null},{QuestionName:Shift Length,AnswerValue:8 Hours ,VerityZone:formtext14,QuestionType:Radio,ActualValueFromSolar:null},{QuestionName:Shift,AnswerValue:Days,VerityZone:formtext15,QuestionType:Checkbox,ActualValueFromSolar:null},{QuestionName:Work Days,AnswerValue:Monday-Friday 8:00am - 4:30pm,VerityZone:formtext16,QuestionType:Text,ActualValueFromSolar:null},{QuestionName:Required Qualifications,AnswerValue:• Bachelor degree in related area and / or equivalent experience / training.u003cbru003e• Minimum 3 years related experienceu003cbru003e• Proven ability to apply external regulatory guidelines and internal accounting and administrative policies knowledge and skills to assess and monitor compliance and effectiveness of processes.u003cbru003e• Solid skills to evaluate issues and identify solutions. Demonstrated ability to solve problems and suggest solutions through critical thinking process.u003cbru003e• Excellent time management skills and ability to independently set and meet deadlines while multi-tasking and assigning precedence to competing priorities. Ability to see multiple assignments through to completion on deadline.u003cbru003e• Demonstrated excellent written and verbal communications skills, with the ability to interpret and convey complex clinical finance information in a clear, concise manner. Ability to summarize and present reports and presentations.u003cbru003e• Demonstrated analytical and problem-solving skills, with the ability to evaluate the effectiveness of workflows and systems.u003cbru003e• Demonstrated interpersonal skills to work effectively in a team environment with internal staff in a wide variety of business and clinical areas. Skills to work collaboratively, coordinate and integrate with others throughout the department, hospital and campus. Ability to communicate through all mediums and with all groups and work under pressure of constantly changing deadlines and priorities.u003cbru003e• Thorough knowledge of data management and documentation methods used in provider enrollment u003cbru003e• Working knowledge of Credentialing processes and required medical licensure for valid provider enrollment with governmental agency,VerityZone:formtext3,QuestionType:textarea,ActualValueFromSolar:null},{QuestionName:Preferred Qualifications,AnswerValue:• Certified Provider Credentialing Specialist (CPCS) preferred.,VerityZone:formtext4,QuestionType:textarea,ActualValueFromSolar:null},{QuestionName:License/Certification,AnswerValue:• Certified Provider Credentialing Specialist (CPCS) preferred.,VerityZone:formtext5,QuestionType:textarea,ActualValueFromSolar:null},{QuestionName:Position Type,AnswerValue:Full Time,VerityZone:formtext6,QuestionType:radio,ActualValueFromSolar:null},{QuestionName:Department Name,AnswerValue:Clinical Practice Group,VerityZone:formtext17,QuestionType:text,ActualValueFromSolar:null},{QuestionName:Equal Employment Opportunity,AnswerValue:The University of California San Francisco is an Equal Opportunity/Affirmative Action Employer. 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