The Government/Commercial Program Enrollment & Regulatory Coordinator supports the revenue cycle by managing all aspects of facility enrollment with Medicare and Medicaid, including initial enrollments, revalidations, updates, and ongoing maintenance. This role requires a strong understanding of the detailed and evolving rules that govern participation in federal and state programs.
In addition to government program enrollment, the coordinator oversees commercial payor enrollment and credentialing activities for the organization’s facilities. This includes ensuring accurate and timely submission of applications, maintaining payor records, and supporting operational readiness for commercial billing.
A key responsibility of this position is monitoring Medicare and Medicaid regulatory and policy changes that impact revenue cycle operations. The coordinator evaluates updates from CMS and state Medicaid agencies, synthesizes the information, and distributes clear, actionable guidance across revenue cycle teams to support awareness and education.
The role also plays an important part in managing the regulatory landscape for provider based clinics. The coordinator tracks government payor requirements specific to provider based status, assists in assessing the impact of new regulations, and supports the organization’s response to changes affecting these locations.
Manage end‑to‑end Medicare and Medicaid enrollment processes, including initial applications, revalidations, ownership/structure updates, and change‑of‑information filings.
Oversee commercial payor enrollment and credentialing activities for all facilities, ensuring timely and accurate submission of required documentation.
Maintain comprehensive, audit‑ready records of enrollment statuses, expirations, correspondence, and supporting documents.
Monitor CMS, MAC, and state Medicaid regulatory updates; assess operational impact and translate changes into clear, actionable guidance for revenue cycle teams.
Serve as a subject‑matter expert on government program participation requirements, commercial payor expectations, and enrollment‑related regulatory rules.
Collaborate with compliance, legal, and operational leaders to identify regulatory risks and support mitigation strategies tied to enrollment or billing privileges.
Coordinate closely with Joint Commission accreditation teams, compliance, and internal/external legal counsel to ensure enrollment activities align with regulatory, accreditation, and organizational requirements.
Participate in facility structure meetings and track agenda items to ensure new additions or modifications are captured and incorporated into enrollment and regulatory workflows.
Support provider‑based clinic regulatory oversight by tracking location‑specific requirements, evaluating new regulations, and coordinating organizational responses.
Partner with IT and revenue cycle operations to ensure enrollment data is accurately reflected in billing systems and aligned with payor requirements.
Develop and maintain standard operating procedures, workflows, and training materials related to enrollment and regulatory updates.
MINIMUM REQUIREMENTS
Education: Bachelor’s degree required or relevant experience may be considered in lieu of Bachelor's degree.
Experience: A minimum of five years of experience required in a complex hospital setting Knowledge of third party billing and reimbursement methodologies required Understanding of CPT level II and III HCPCS and hospital charging methods is essential General comprehension of medical terminology is necessary.
Licensure: none
PHYSICAL DEMANDS
Job requires sitting for prolonged periods, frequently traveling (no more than two miles); Repetitive motion: (Typing). Proficient communicative, auditory and visual skills; Attention to detail and ability to write legibly; Ability to lift/push/pull less than 20lbs. May be exposed to cold, heat and outdoor climate.
The starting base rate for this role is $85,000.00 annually. Individual compensation will be determined by the selected candidate's qualifications, previous work experience, and/or education.
Benefits
Comprehensive Benefits Package: Medical, Dental, and Vision Insurance
Paid Time Off, Long-term and Short-term Disability, Retirement Savings
Health Saving Plans, and Flexible Spending Accounts
Certification and education support
Generous Paid Time Off
UVA Health is a world-class Magnet Recognized academic medical center and health system with a level 1 trauma center. 2023-2024 U.S. News & World Report “Best Hospitals” guide rates UVA Health University Medical Center as “High Performing” in 5 adult specialties and 14 conditions/procedures. We are one of 70 National Cancer Institute designated cancer centers. UVA Health Children’s is named by 2023-2024 U.S. News & World Report as the best children's hospital in Virginia with 9 specialties ranked among the best in the nation. Our footprint also encompasses 3 community hospitals and an integrated network of primary and specialty care clinics throughout Charlottesville, Culpeper, Northern Virginia, and beyond.
The University of Virginia is an equal opportunity employer. All interested persons are encouraged to apply, including veterans and individuals with disabilities. Learn more about UVA’s commitment to non-discrimination and equal opportunity employment .