AdventHealth Corporate

All the benefits and perks you need for you and your family:

· Benefits from Day One

· Career Development

· Whole Person Wellbeing Resources

· Mental Health Resources and Support

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

Shift : Full-time; Monday-Friday

Job Location : Altamonte Springs, FL

The role you will contribute:

The Regulatory Licensure and Enrollment Specialist, under the guidance of the Director of Regulatory Licensure and Enrollment, is responsible for understanding facility licensure requirements as well as Medicare and National Plan and Provider Enumeration System (NPPES) enrollment processes to best be able to assist with the required monitoring, creation, and maintenance functions for the AdventHealth System. In addition to contributing to the assurance of operational compliance with facility specific licensure and enrollment regulations, this position assists with research and actions for related licensure and enrollment and required filings, as well as obtaining and providing required information to external stakeholders in a timely manner. The Regulatory Licensure and Enrollment Specialist must be able to develop strong working relationships with AdventHealth executives, Regulators, and other internal and external stakeholders. A Regulatory Administration Specialist adheres to AdventHealth policies and procedures and actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.

The value you will bring to the team:

LICENSURE & ENROLLMENT:

Includes new and existing enrollments, licenses, and permits for AdventHealth hospitals and non-hospital-based providers, such as hospitals, home health, hospice, ambulatory surgery centers, and independent diagnostic treatment facilities.

· Utilizes various external applications to perform licensure and enrollment duties such as PECOS (Provider Enrollment Chain of Ownership System), AHCA (Agency for Health Care Administration), NPPES (National Plan & Provider Enumeration System), CMS I & A (Center for Medicare and Medicaid Identity & Access), and various state Medicaid and state licensure systems.

· Updates the internal licensure and Medicare and Medicaid enrollment inventories to provide a comprehensive listing of facilities supported.

· Monitors status and updates project status listings for licensure and enrollment as requested. Projects may include new projects; facility construction, laboratory, pharmacy, and others.

· Evaluates new and existing licenses & enrollment applications to determine what information must be gathered, researched, or obtained from internal and external sources.

· Assists with the creation and submission of licensure and enrollment applications as required by facility type and state and federal requirements. This may include new applications, renewals, changes/updates, etc.

· Investigates and tracks progress of required applications and other regulatory items throughout the submission process and follows up as needed to ensure timeliness.

· Actively participates in assigned group meetings and discussion where regulatory opinion is sought and provided.

· Communicates with fiscal intermediaries, State, and Federal agencies as directed.

· Creates, maintains and organizes electronic records via Teams Channels and Once Drive of necessary licensure and enrollment files.

· Assists with obtaining necessary leadership signatures on applications, forms, and cover letters

· Requests and tracks payments to regulatory agencies for bed additions, new offsite locations, and changes in services or programs.

· Tracks license and enrollment renewals and revalidations for hospital, home health, hospice, ambulatory surgery center, and laboratory locations.

· Assures license and enrollment approvals are distributed to key stakeholders such as Managed Care, PFS, facility executives, etc..

· Maintains NPPES system and updates with any necessary changes.

· Works with facility contacts to validate all information on the enrollment and obtain necessary supportive documentation.

· Communicates with billing and revenue team members as needed to facilitate matching of the enrollment to the billing system to comply with Medicare billing requirements.

· Uses judgement to determine how best to filter and present reports and regulatory data for authorized stakeholders.

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Special Projects

· Coordinates annual hospital, home health, and hospice state required proof of liability coverage efforts.

· Assists with creation of departmental database to store key regulatory information.

· Performs other duties as assigned or directed with limited supervision.

The expertise and experiences you’ll need to succeed:

· Bachelor’s degree in health law, healthcare administration, business, communications or other related or approved field.

Preferred Qualifications:

· Experience in healthcare, healthcare compliance, healthcare regulations or Medicare and/or Medicaid enrollment.

· Three to five years of work experience in hospital compliance, health information, patient registration or patient billing operations; or another related field

· Notary Certification for the State of Florida

· Certification in Health Care Compliance

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location.

Category: Operations

Organization: AdventHealth Corporate

Schedule: Full-time

Shift: 1 - Day

Req ID: 25003968

We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.