Payer Enrollment Contract Specialist
Payer Enrollment Contract Specialist
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1 Vacancy
Job Description
Job Description Summary:
At Logan Health were more than just a healthcare providerwere a community. Nestled in the heart of Montana we are committed to delivering exceptional care to our patients while fostering a supportive and collaborative work environment for our team. As a member of Logan Health youll be part of a dynamic team that values compassion innovation and excellence. We offer opportunities for growth comprehensive benefits and a chance to make a meaningful impact in the lives of those we serve. Come join us and experience the Logan Health difference where your passion meets purpose in a place youll be proud to call home.Are you ready to make a meaningful impact in healthcare by ensuring the seamless flow of payer enrollment and contracting processes At Logan Health we are seeking a meticulous and detailoriented Payer Enrollment Contract Specialist to join our dynamic team. Your role will be pivotal in managing payer enrollment processes ensuring compliance with regulations and building strong partnerships that drive our mission forward.
Hybrid Work Schedule:
This role follows a hybrid schedule with three 3 onsite days in Kalispell and two 2 remote days per week based on business needs and team coordination.
Key Responsibilities:
Manage Provider and Facility Enrollment: Take the lead in ensuring the timely and accurate submission of new provider group and facility enrollment applications across multiple insurance platforms. This includes revalidations updates and terminations for both commercial and government payers ensuring all information remains current and compliant.
Maintain Provider Records: Ensure all provider credentials licenses certifications and recredentialing documents are uptodate within internal systems and external databases. Proactively track expiration dates and renewals to avoid any lapses in coverage or credentialing.
Compliance & Regulatory Knowledge: Stay informed on evolving healthcare regulations payer policies and enrollment standards. Ensure that all processes adhere to federal state and payerspecific guidelines including HIPAA and Medicare requirements.
Liaison with Stakeholders: Serve as the main point of contact for providers internal departments and insurance payers. Facilitate smooth communication between all parties to resolve enrollment issues efficiently and maintain seamless payer relationships.
Provider Support & Issue Resolution: Respond promptly to inquiries from providers and internal managers regarding enrollment matters. Troubleshoot issues related to enrollment billing and payer credentialing to ensure continuous and uninterrupted coverage for providers.
Database & System Management: Ensure accurate and timely data entry of all providerrelated information into payer systems and internal databases. Regularly audit these systems to ensure compliance and resolve discrepancies swiftly.
Enhance Enrollment Processes: Continuously seek ways to improve payer enrollment workflows. Collaborate with crossfunctional teams to identify areas for optimization and implement strategies that streamline processes and reduce administrative bottlenecks.
Basic Qualifications:
3 years of experience in an administrative role.
Proficiency in Microsoft Office Suite with intermediate knowledge of Microsoft Excel including data entry formulas and basic functions.
Preferred Qualifications:
Experience working with Commercial and Government Payers to ensure proper claims processing and reimbursement.
Experience working with highlevel and senior leadership demonstrating a strong ability to manage sensitive situations with professionalism.
A background in healthcare or customer service with an understanding of medical terminology.
Strong attention to detail and the ability to prioritize tasks in a fastpaced environment.
Excellent communication and interpersonal skills to collaborate effectively with diverse teams and stakeholders.
Ability to handle sensitive and confidential information with professionalism and diplomacy.
Demonstrated problemsolving skills and the ability to think critically and independently in complex scenarios.
Shift:
Day Shift 8 Hours (United States of America)Schedule Details:
Please know schedules and shifts are subject to change based on patient care and department/organizational needs.
This role follows a hybrid schedule with three 3 onsite days in Kalispell and two 2 remote days per week based on business needs and team coordination.
We are committed to creating a supportive teamdriven environment where your skills can flourish. Our organization operates 24/7 offering flexibility in your schedule while empowering you to be a part of something biggerimproving healthcare outcomes for all.
Schedules are set to accommodate the requirements of the position and the needs of the organization and may be adjusted as needed.
Notice of PreEmployment Screening Requirements
If you receive a job offer please note all offers are contingent upon passing a preemployment screening which includes:
Criminal background check
Reference checks
Drug Screening
Health and Immunizations Screening
Physical Demand Review/Screening
Equal Opportunity Employer
Logan Health is an Equal Opportunity Employer (EOE/AA/MF/Vet/Disability). We encourage all qualified individuals to apply for employment. We do not discriminate against any applicant or employee based on protected veteran status race color gender sexual orientation religion national origin age disability or any other basis protected by applicable law. If you require accommodation to complete the application testing or interview process please notify Human Resources.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
