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About the Role
The Payer Enrollment Analyst ensures all regional hospital-based providers are credentialed with applicable payers accurately and timely. This role involves coordination with various internal and external stakeholders to manage the enrollment process.
Responsibilities
- Coordinates completion and submission of initial applications for third-party payer enrollment for all Southern Region billing Providers.
- Completes and submits all provider changes to payers as required.
- Acts as a liaison to CBO payer enrollment, URMC MSS IT, and Credential Stream to develop and establish various workflows for enrollment processing.
- Completes recertifications/revalidations for third-party payers.
- Maintains CAQH files, including re-attestations and uploading required data.
- Performs all revalidations for providers as required by CMS and commercial payers.
- Communicates with third-party payers to establish new practice locations, including CMS.
- Submits required documentation to payers upon termination of a provider.
- Maintains workflows to ensure enrollment completion for every payer/provider requested.
- Responsible for maintaining the AHP database, ensuring all providers are correctly enrolled.
- Responsible for web-based payer website provider directories, attestations, and compliance.
- Responsible for monitoring and updating all payer rosters.
- Responsible for review of all current payers’ use of enrollment form versions.
- Acts as liaison working with URMC MSS IT team and payer enrollment software vendor to establish accurate forms mapping.
- Responsible for reporting as requested.
- Responsible for documenting all Department processes.
- Responsible for Department training material maintenance.
- Responsible for training new associates as designated preceptor.
- Responsible for monitoring SharePoint related department use and troubleshooting issues.
- Responsible for the intake and coordination of all provider enrollment requests and tracking in the Manager's absence.
- Required to attend scheduled meetings with each hospital, provide status of enrollments, and lead in the Manager's absence.
Requirements
- Associate degree and 2 years of work-related experience in a healthcare setting required.
- Professional billing experience preferred.
- 2 years of previous medical billing experience preferred or related healthcare experience.
- Excellent customer relations and communications skills.
- Skills in using computers including Excel, Word, Box, Teams, SharePoint, and internet use required.
- Working knowledge of third-party payers.
- Excellent Attention to detail.
Skills
- Excel
- Word
- Box
- Teams
- SharePoint
- Internet use
- Third-party payer knowledge
- Customer relations
- Communication skills
- Attention to detail
Location
- Onsite
Work Type
- Onsite
- Full-time
Experience Level
- 2 years
Education Level
- Associate degree
Salary/Compensations
- $24.00 - $30.00 per hr
About the Company
- Thompson Health is an EOE encouraging individuals with disabilities and veterans to apply.
Equal Opportunity
- EOE encouraging individuals with disabilities and veterans to apply.