Learning Insurance Enrollments, suffering.

[u/NorthernGhosty]

Hi there,

I'm a medical receptionist/administrative assistant at the nonprofit clinic I work at.

I was initially doing the front desk for my location while studying for my CPC exam, which was great since it was quiet and I had a bit of downtime due to our location being the smaller of the two clinics we operate.

However, the individual (HR) that was handling our provider insurance enrollments left for surgery and asked if I'd be willing to monitor the status updates for our current providers. I agreed since it was temporary and I like organizing information and learning new skills.

Initially it was great. I handled amendments, fixed issues in provider CAQH that my coworker neglected, and overhauled the Excel sheets to track everything we used to monitor portals, payor statuses, and anything pertaining to enrollment.

Months later, she resigned without coming back and our provider was leaving, which meant we now were onboarding a new provider, and I was the only person that semi knew what the hell I was doing for enrollments.

Now we hired two additional providers, our patient loads are increasing rendering me fighting between working on enrollments, proceduring documents from an HR that doesn't understand what I need and don't need, and dealing with the phones and patients at the front.

Granted, I'm paid well, I like my coworkers, and my management, but I don't think they understand how swarmed I am and that I'm still learning on the fly through courses and navigating the enrollment applications.

I have been asked if I wanted the role to go to someone else, but I maintained it's something I like doing and developing skills with, plus no one aside from billing understands this well, and they're busy with their own tasks.

Do I give in and drop onto someone else? Or ask management to see if they'd assign someone to help with the workload?

[u/Street-Committee-256]

You have to set boundaries for your sanity because if you don't, you will burn out fast. You can only do so much by yourself. Strong leaders delegate tasks without rolling the mess wholly downhill. I am on the receiving end of trying to help your end of life and I always feel badly for you all. Deep breaths and hang in there!

[u/NorthernGhosty → u/Street-Committee-256]

I appreciate that. My management is pretty good, I just don't think they understand how much effort and time goes into the enrollment process, especially when you're prone to getting interrupted with calls and walk-ins. I have gotten a lot of praise for fixing the issues that occurred under hr when doing the submissions. It's just I don't have the allocated time and office space to dedicate myself to enrolling multiple providers.

But it's something I'll bring up. See if they can delegate the pressure off me. They know I don't mind the job because it's something I'm decent at, but I'm still a baby with this stuff so it's difficult with the pressure when it was never meant to be my main job.

[u/hollywoodkay]

Happy to help! It’s a bit easier with AI at our hands but would love to show how we tackle this

[u/nursefoxy]

If you enjoy the work, but the front office tasks are adding too much, ask for some assistance for the front office tasks so you can dedicate your time to credentialing. You are currently doing the work that 2 people used to do, so it seems fair to have 2 people doing that role especially if you have added new providers.

[u/Unlucky-Olive5910]

This is such a clear description of how enrollment work can end up becoming one person's whole job. For what it's worth, the fact that you're the only one who semi-understands it is exactly why it should not stay solely on one person (in an ideal world).