Summary

Munson Healthcare is a comprehensive regional healthcare system serving northern Michigan and the surrounding areas. As a leading healthcare provider in the region, Munson Healthcare operates multiple hospitals, medical centers, and outpatient facilities across a 25-county service area. The system is anchored by Munson Medical Center in Traverse City, which serves as the region's tertiary referral center and Level II Trauma Center. Munson Healthcare provides a full spectrum of medical services including primary care, specialty care, emergency services, surgical services, cancer care, heart and vascular services, women's health, and behavioral health services. The organization is committed to delivering high-quality, patient-centered care while also focusing on community health initiatives and preventive care programs. With a strong emphasis on clinical excellence and innovation, Munson Healthcare collaborates with academic medical centers and participates in clinical research to bring advanced medical treatments to the communities it serves. The healthcare system plays a vital role in the regional economy and public health infrastructure of northern Michigan.

Job description

Job Description

Lead and coordinate all payor enrollment activities, ensuring timely submissions, approvals, and maintenance of active provider enrollments.
Serve as the primary escalation point for complex enrollment and credentialing issues, partnering with health plans to resolve challenges and implement solutions.
Monitor enrollment operations, including status updates, team inquiries, audits, KPI reporting, and final review of payer submissions.
Collaborate with credentialing, onboarding, revenue cycle, and operational teams to support provider onboarding, enrollment compliance, and resolution of enrollment-related denials and underpayments.

Qualifications

Bachelor's degree required.
Minimum of five (5) years of experience in physician services, revenue cycle, or another healthcare-related field required.
Three (3) years of management or leadership experience preferred.
Knowledge of payor requirements required; knowledge of NCQA credentialing standards and the ability to interpret data within computerized information systems preferred.

Requirements

Bachelor's degree required
Minimum of five (5) years of experience in physician services, revenue cycle, or another healthcare-related field required
Three (3) years of management or leadership experience preferred
Knowledge of payor requirements required
Knowledge of NCQA credentialing standards preferred
Ability to interpret data within computerized information systems preferred

Benefits

Medical exemption
Religious exemption

Company overview

Munson Healthcare is a comprehensive regional healthcare system serving northern Michigan and the surrounding areas. As a leading healthcare provider in the region, Munson Healthcare operates multiple hospitals, medical centers, and outpatient facilities across a 25-county service area. The system is anchored by Munson Medical Center in Traverse City, which serves as the region's tertiary referral center and Level II Trauma Center. Munson Healthcare provides a full spectrum of medical services including primary care, specialty care, emergency services, surgical services, cancer care, heart and vascular services, women's health, and behavioral health services. The organization is committed to delivering high-quality, patient-centered care while also focusing on community health initiatives and preventive care programs. With a strong emphasis on clinical excellence and innovation, Munson Healthcare collaborates with academic medical centers and participates in clinical research to bring advanced medical treatments to the communities it serves. The healthcare system plays a vital role in the regional economy and public health infrastructure of northern Michigan.