Program Operations Specialist

Job Description

UW MEDICINE'S CHARGE MASTER REVENUE INTEGRITY DEPARTMENT has an outstanding opportunity for a REVENUE INTEGRITY ENROLLMENT SPECIALIST.

SCHEDULE

Weekdays

100% Remote

DEPARTMENT DESCRIPTION

UW Medicine's Revenue Integrity Department is a shared services organization, which supports all of UW Medicine.  UW Medicine entities include but are not limited to UW Medical Center (UWMC), Harborview Medical Center (HMC), UW School of Medicine, Northwest Hospital, UW Neighborhood Clinics (UWNC) and UW Physicians.

POSITION HIGHLIGHTS

Under the general guidance of the Director of Revenue Integrity, the Revenue Integrity Enrollment Specialist is responsible for overseeing and coordinating the provider enrollment process for both new and established providers.  This includes gathering and verifying primary source documentation required for initial enrollment and revalidation applications, ensuring completeness and accuracy in accordance with health plan requirements.

The role is responsible for submitting and managing enrollment applications with government and commercial payers, monitoring application status and resolving issues to ensure timely approvals.  The Revenue Integrity Enrollment Specialist maintains accurate enrollment records and ensures providers are properly enrolled and linked to the appropriate entities, locations and payer networks.

PRIMARY RESPONSIBILITIES    

• Works with necessary individuals-including physicians, internal customers, other professional staff and their office or clerical staff-to acquire necessary materials and information for provider certification and licensure
• Notifies applicants when additional information is requested regarding their background, training, demonstrated ability previous performance, current competence, physical and mental health status, etc.
• Performs ongoing provider maintenance for accuracy and completeness
• Tracks and manages provider initial enrollment/onboarding and revalidation applications, including primary source verification, preparation of payer and regulatory correspondence, and monitoring responses within UW Medicine’s provider database
• Safeguards the integrity of privileged information and credential files in a professional, sensitive manner
• Collaborates with physicians, internal stakeholders, and administrative staff to obtain required documentation for provider certification, licensure, and enrollment
• Communicates with applicants regarding requests for additional information related to background, training, experience, current competence, and other enrollment
• Performs ongoing provider maintenance to ensure accuracy, completeness, and compliance with payer and regulatory standards
• Maintains confidentiality and safeguards privileged and sensitive provider information in a professional manner
• Gathers and assembles documentation related to denial trends and root causes for Revenue Integrity Denial Taskforce members
• Specifically acts as liaison between providers, department managers and payers for claim denial prevention

REQUIRED

Bachelor's Degree

Certification - National Association of Medical Staff Services (NAMSS preferred)

4-6 years experience of administrative experience working within a hospital or healthcare setting
4-6 years experience working directly with hospital personnel such as physicians and allied health practitioners
4-6 years of experience working in one of the following areas: financial clearance, credentialing, billing, denial or case management

Equivalent experience may substitute for degree requirement

ABOUT UW MEDICINE – WHERE YOUR IMPACT GOES FURTHER

UW Medicine is Washington’s only health system that includes a top-rated medical school and an internationally recognized research center. UW Medicine’s mission is to improve the health of the public by advancing medical knowledge, providing outstanding primary and specialty care to the people of the region, and preparing tomorrow’s physicians, scientists and other health professionals.

All across UW Medicine, our employees collaborate to perform the highest quality work with integrity and compassion and to create a respectful, welcoming environment where every patient, family, student and colleague is valued and honored. Nearly 29,000 healthcare professionals, researchers, and educators work in the UW Medicine family of organizations that includes: Harborview Medical Center, UW Medical Center - Montlake, UW Medical Center - Northwest, Valley Medical Center, UW Medicine Primary Care, UW Physicians, UW School of Medicine, and Airlift Northwest.

Become part of our team. Join our mission to make life healthier for everyone in our community. 

Compensation, Benefits and Position Details

Pay Range Minimum:

$38.54 hourly

Pay Range Maximum:

$44.26 hourly

Other Compensation:

-

Benefits:

For information about benefits for this position, visit https://www.washington.edu/jobs/benefits-for-uw-staff/

Shift:

First Shift (United States of America)

Temporary or Regular?

This is a regular position

FTE (Full-Time Equivalent):

100.00%

Union/Bargaining Unit:

Not Applicable

About the UW 

Working at the University of Washington provides a unique opportunity to change lives – on our campuses, in our state and around the world.  

UW employees bring their boundless energy, creative problem-solving skills and dedication to building stronger minds and a healthier world. In return, they enjoy outstanding benefits, opportunities for professional growth and the chance to work in an environment known for its diversity, intellectual excitement, artistic pursuits and natural beauty. 

Our Commitment 

The University of Washington is committed to fostering an inclusive, respectful and welcoming community for all. As an equal opportunity employer, the University considers applicants for employment without regard to race, color, creed, religion, national origin, citizenship, sex, pregnancy, age, marital status, sexual orientation, gender identity or expression, genetic information, disability, or veteran status consistent with UW Executive Order No. 81.

To request disability accommodation in the application process, contact the Disability Services Office at 206-543-6450 or dso@uw.edu. 

Applicants considered for this position will be required to disclose if they are the subject of any substantiated findings or current investigations related to sexual misconduct at their current employment and past employment. Disclosure is required under Washington state law.