Payer Enrollment Specialist
Payer Enrollment Specialist
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Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
Job Details
Description
Duties may include but are not limited to:
- Initiates and supports payer enrollment process by requesting receiving validating and submitting payer enrollment applications for new providers and provider changes
- Completes payer revalidations for providers and entities on payerspecific cadence
- Maintains and manages payer portal access for providers and entities
- Provides updates to payers on provider and entity records related to banking information EFT correspondence address ownership etc.
- Responsible for accurate data entry to ensure data integrity
- Maintains accurate records in payer enrollment software and on shared drive
- Collaborate with Revenue Cycle department on claim denials rejections or inquires due to enrollment
- Communicates with payer representative to address payer concerns
- Responds to all practitioner health plan and internal inquiries in a timely manner
- Collaborates with participating clients department manager and /or external agencies to facilitate and ensure smooth handoff during the payer enrollment process
- Uses critical thinking skills to conduct followup with individual practitioners and internal and external entities to resolve discrepancies identified during the payer enrollment process
REQUIRED EDUCATION SKILLS & EXPERIENCE:
Bachelors degree in business healthcare or related filed and 35 years of progressive experience in payer enrollment strongly preferred. 10 years of credentialing/enrollment and/or revenue cycle management experience may be substituted in place of a degree.
PHYSICAL/MENTAL/ENVIRONMENTAL DEMANDS
Requires sitting and standing associated with a normal office environment. Travel (local and nationwide) as business needs dictate.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
