Sr Government Enrollment Specialist
Location: Irvine, CA
At Alliance HealthCare Services, our focus is on transforming the customer and patient experience. Vital to our success are the Corporate Team Members who collaborate with clinical, operational, and sales teams in the field. We focus on delivering improved processes, innovative new services, and business solutions that differentiate and advance our comprehensive clinical services—always with our patients’ and customers’ needs in mind.
The Sr. Government Enrollment Specialist will implement all aspects of Alliance Healthcare Services government healthcare provider Medicare and Medicaid enrollment programs. The primary responsibility is to ensure that Alliance Healthcare Services is in 100% compliance with all Medicare and Medicaid regulations and timely filing requirements. This is a corporate level task that requires the Senior Government Enrollment Specialist to work directly with all other Alliance Healthcare Services departments and divisions to provide the requisite information needed to complete initial and revalidation applications accurately and within the timeframe required by Medicare and Medicaid. In the event Medicare or Medicaid sends back a development request, the Senior Government Enrollment Specialist will ensure accurate and timely responses that include engaging the legal department to develop an appeal when Alliance Healthcare Services disputes the position Medicare or Medicaid is taking related to any particular regulation. The role is responsible for ensuring that all Alliance Healthcare Services independent diagnostic testing facilities (“IDTFs”) pass onsite inspections by Medicare and State Medicaid inspectors in order to remain compliant with the IDTF performance standards and other Medicare/Medicaid requirements. The Senior Government Enrollment Specialist is a subject matter expert on Medicare and Medicaid regulation and acts in the capcity of being a resource to others in the company.
Specific duties include, but are not limited to:
- Ensures the 100% accurate and 100% timely compliance of government provider enrollment applications and updates, as well as ensures that IDTF inspections are passed and IDTF performance standards and other Medicare/Medicaid requirements are compliant. Meets or exceeds all personal Key Performance Indicators (KPI’s).
- Responds to all “developments”, “rejections”, and “requests for additional information” submitted by Medicare/Medicaid accurately and timely.
- Participates in all aspects of the Government Enrollment department projects including process improvement initiatives and implementation of processes to improve efficiency and effectiveness of the team.
- Manages all incoming enrollment requests by logging them accurately into the enrollment department tracking log and by assigning tasks out to the other enrollment team members.
- Ensures that all other internal departments provide requested information and signatures timely. Develops tracking mechanisms to ensure follow up with other departments when they have not provided necessary information within the allotted timeframe needed to complete the filing timely.
- Bachelor's degree or equivalent experience required.
- Experience with IDTF Medicare/Medicaid enrollment including direct knowledge of the approximate 1,400 pages of Medicare regulations that govern IDTF’s required.
- Direct interaction with the Medicare MAC’s and the State Medicaid Agencies.
- Updating and managing the accuracy of the Alliance data stored in the Medicare PECOS system.
- Highly organized with excellent written and verbal communication skills.
- Excellent analytical skills, to include the ability to read, extract and interpret information.
- Good logic, problem solving and project implementation skills.
- Highly skilled producing very detailed work with 100% accuracy.
- Experience creating, using and manipulating Excel Spreadsheets.
- Ability to perform comfortably in a fast-paced deadline-oriented work environment.
- Microsoft Office skills required.
- Must be independent and self-motivated requiring minimal supervision.
- Knowledge of the ViStar eVips system a plus.
- Previous employment by Medicare, or a State Medicaid agency, or direct interactions with the various geographic Medicare MAC’s a plus.
- Previous experience working with complex ownership structures and accurately reporting those ownership structures to Medicare and Medicaid a plus.
- Previous experience appealing CMS, MAC and Medicaid negative decisions.
A division of Alliance HealthCare Services (NASDAQ: AIQ), we are an equal opportunity employer and we believe in strength through diversity. All qualified applicants will receive consideration for employment without regard to, among other things, race, religion, color, national origin, sex, sexual orientation, gender identity & expression, status as a protected veteran, or disability.