Provider Enrollment Supervisor

Type of Requisition:

Regular

Clearance Level Must Currently Possess:

None

Clearance Level Must Be Able to Obtain:

None

Public Trust/Other Required:

None

Job Family:

Healthcare Claims

Job Qualifications:

Skills:

Communication, Employee Performance Evaluations, Give Feedback, Provider Enrollment, Supervision

Certifications:

None

Experience:

3 + years of related experience

US Citizenship Required:

No

Job Description:

Healthcare Claims Supervisor

NCTracks was implemented by CSRA in July 2013 and used by the Division of Health Benefits (DHB); the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services (DMH/DD/SAS); and the Division of Public Health (DPH).  CSRA is the fiscal agent for NC DHHS and handles the daily operations and functionality enhancements to NCTracks.

Providers enrolled in DHB, DMH/DD/SAS and DPH health plans submit claims for payment of covered health care services through the NCTracks Provider Portal and to pre-paid health plans. NCTracks coordinates processing among the payers to ensure the proper assignment of the payer, benefit plan and pricing methodology for each service on a claim. NCTracks processes health care claims, prior approval requests, provider enrollment, finance, and other healthcare transactions. We are looking for a Provider Enrollment Operations Supervisor to join our team.

Duties and Responsibilities:

• Supervises, hires, trains, evaluates and disciplines employees.
• Conducts performance evaluations and provides continuous feedback.
• Plans, organizes and controls the daily operation of the Provider Enrollment Team.
• Develops and implements policies and procedures to increase efficiency and productivity.
• Assesses the work performance of the Provider Enrollment Team to identify areas that need improvement.
• Assigns staff to the various enrollment operations and instructs them when necessary so they are trained to perform assigned duties in accordance with established business rules and desk procedures.
• Provide team with communication impacting Provider Enrollment.
• Provides exceptional customer service and maintains proper communication with the client and other departments.
• Acknowledge and follow up with Team Leads and Enrollment Specialist on their questions and concerns.
• Conduct Team Meetings, as needed, with minutes attached.
• Plans and implements various events and team building activities to boost employee morale and engagement.
• Advocate for employee needs and interests to grow within the organization.
• Review and validate timesheets for accuracy. Approve timesheets and Leave Requests in a timely manner.
• Review the Quality Control Analysts’ internal quality audits, DHB audits, and other quality findings with the Enrollment Specialists monthly.
• Provides feedback to Enrollment Specialists answering questions, explaining procedures and policies as required.
• Serve as the backup for the other Enrollment Supervisor.
• Collaborates with the Provider Enrollment Manager in the development of new and existing desk procedures to meet future needs.
• Escalate team HR issues to Manager.
• Providing information to Manager when requested.
• Performs related duties as required.

Qualifications:

• Bachelor’s degree in Business, Finance, Health Care or related field preferred; or high school diploma and appropriate combination of education and experience.
• Minimum of 5 years related experience required; 1 – 3 years of experience leading credentialing teams.
• Working knowledge of Medicaid and NCQA credentialing certification regulations, policies and procedures.
• Ability to communicate and collaborate with internal and external professionals, including stakeholders and providers.
• Exceptional verbal and written communication aptitude, with proven ability to positively influence behavior. Conflict resolution and change management competency.
• Ability to handle confidential and sensitive information.
• Empathy and the ability to relate to employees at all levels.
• Process and operational improvement experience required.
• Ability to train/coach new hires and existing staff.
• Highly self-directed, motivated and able to work independently with minimum level of supervision. Strong computer skills a necessity.

The likely salary range for this position is $72,509 - $95,750. This is not, however, a guarantee of compensation or salary. Rather, salary will be set based on experience, geog