Provider Enrollment and AR Specialist

Muncie, IN - USA

Monthly Salary: Not Disclosed

Posted on: 8 hours ago

Vacancies: 1 Vacancy

Job Summary

Provider Enrollment and AR Specialist

Summary:

Under the direction of the Revenue Cycle Manager this positionis responsible for the timely and successful submission and completion of government and commercial insurance enrollment paperwork for all ODHS providers and assist Revenue Cycle manager with special reporting and projects.

This is a fulltime 40 hours per week Monday through Friday position.

Responsibilities (How this position enhances our Mission Vision and Values)

Mission Improve the Quality of Life of Others:

Compiles creates and updates information for use by staff for the appropriate utilization of specific health plans IPAs Managed care etc. and responds to questions for clarification.
Accomplishes provider enrollment/disenrollment operations including application submission enter applications into system and submission to CMS and other insurances.
Acts as a resource regarding provider status with various health plans/programs.

Vision Be the Preferred Partner for Improving Well-Being:

Routinely following up with insurance carriers to determine the status of submitted applications and resolve issues.
Regularly updates manager of concerns or problems with credentialing process.
Comply with all agency policies and procedures concerning corporate compliance including privacy of protected health information.
Maintains files for documentation of enrollments disenrollments and revalidation.

Values Esteem the Team Maximize Potential Do the Right Thing Choose Compassion Encourage Uniqueness:

Completes review and follow up of information submitted processing of fees completion of forms ensures accuracy and detail.
Completed and monitors provider enrollment and revaluations of Medicare/Medicaid and MCOs to ensure participation date.
Prepare correspondence memos and reports as directed.
Keep up to date files of all correspondence memos and agreements.
Stay current and understand enrollment and specific application requirements for all carriers.
Assist Revenue cycle manager with reporting and other special projects as needed.
Works through un-postable items in EMR system as assigned.
Obtain NPI (National Provider Identification) Medicare/Medicaid numbers for any new ODHS sites.
Other duties as assigned.
Skill in establishing and maintaining effective working relationships with clinic staff patients medical and dental staff and the public.
Skill in identifying and resolving problems.
Able to work creatively with management and department staff to achieve objectives.
Communicate effectively and timely with all levels of management regarding enrollment updates/issues.
Ability to maintain confidentiality of financial payroll patient information and personnel matters.
Good communication skills and ability to work closely with others and in teams.
Willing to continually update skills and knowledge regarding healthcare procedures.

Education and Experience:

High School diploma or GED equivalency preferred.
Experience in a health care setting and/or in an office preferred.
Experience with provider enrollment with Medicare Medicaid and commercial payers preferred.
Knowledge of NCQA Standards and medical terminology.
Knowledge of CAQH

About you:

Ability to prioritize work assignments work independently and perform duties efficiently with minimal supervision
Expertise in Microsoft software products including Word Excel and Outlook
Must be detail oriented and thorough in order to ensure the complex enrollment packages are complete and correct.
Skill in exercising initiative listening judgment discretion and decision-making within the guidelines of the policies procedures and standing orders of the Health Center.
Possess understanding of individuals socio-economic status and life-style with respect for individual differences.
Participates in professional development activities.
Able to multi-task.
Can work under pressure and meet deadlines.
Able to work with a high degree of precision and attention to detail.
Able to react calmly and effectively in emergency situations.
Great telephone and computer skills.
Able to work unsupervised.
Requires hand-eye coordination manual dexterity sufficient to operate a computer keyboard copy machine phone calculator and other office equipment.
Must be able to hear normal range of voice.

Physical and Environmental Requirements:

Work is performed in a normal office environment.
May require driving to all clinic sites.
May also require travel and occasional evening or weekend work.
Requires sitting for long periods of time.
Requires occasional bending stretching or lifting.
Must be able to work under stressful conditions during some periods of time.

Required Experience:

Provider Enrollment and AR SpecialistSummary: Under the direction of the Revenue Cycle Manager this positionis responsible for the timely and successful submission and completion of government and commercial insurance enrollment paperwork for all ODHS providers and assist Revenue Cycle manager with ...