PAYER ENROLLMENT ANALYST

Thompson-Health; City of Canandaigua (NY); On-site; USD 33,000 - 41,000; Full time

Job summary

Thompson Health is seeking a Payer Enrollment Analyst to work onsite in the Southern Region, coordinating provider enrollment with payers and third parties. The role involves managing CAQH files, revalidations, and workflow development across departments.

You will liaise with hospital providers, IT teams, and payers to ensure timely enrollment, change submissions, and data integrity. Strong communication and billing experience are essential.

Qualifications

• Associate degree and 2 years’ work-related experience in health care setting required.
• Professional billing experience preferred.
• Excellent customer relations and communications skills

Responsibilities

• Coordinates completion of initial applications for third party payer enrollment for all Southern Region billing Providers (6 hospitals/5 health systems)
• Coordinates submission of signed applications to third party payers for enrollment for all Southern Region billing Providers (6 hospitals/5 health systems)
• 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 workflows for enrollment processing.
• Completes recertifications/revalidations for third party payers.
• Maintains CAQH files including re-attestations and uploading required data with documented permissions.
• Performs all revalidations for all providers as required by CMS and commercial payers.
• Communicate with all third-party payers to establish new practice locations including CMS.
• Timely submits required documentation to payers upon termination of provider.
• Maintains workflows to ensure enrollment completion for every payer/provider requested.
• Responsible for maintaining 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 as requested.
• 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 requesting
• 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 Managers absence.
• Required to attend scheduled meetings with each hospital, provide status of enrollments and lead in Managers absence.

Education

Associate degree

Tools

Excel

Word

Box

Teams

SharePoint

Job description

Schedule: M-F 8:00am - 4:30pm (This role is onsite)

Main Function

The Payer Enrollment Analyst works in conjunction with regional Providers, Medical Staff Offices, Associate Services, Legal/Regulatory Affairs, URMC MSS IT, Payer enrollment software vendor and third-party payers to ensure that all regional hospital-based providers are credentialed with all applicable payers timely and accurately. Responsibilities include:

• Coordinates completion of initial applications for third party payer enrollment for all Southern Region billing Providers (6 hospitals/5 health systems)
• Coordinates submission of signed applications to third party payers for enrollment for all Southern Region billing Providers (6 hospitals/5 health systems)
• 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 based on need.
• Completes recertification’s/revalidations for third party payers.
• Maintains CAQH files including re-attestations and uploading required data with documented permissions.
• Performs all revalidations for all providers as required by CMS and commercial payers.
• Communicate with all third-party payers to establish new practice locations including CMS.
• Timely submits required documentation to payers upon termination of provider.
• Maintains workflows to ensure enrollment completion for every payer/provider requested.
• Responsible for maintaining 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 as requested.
• 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 requesting
• 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 Managers absence.
• Required to attend scheduled meetings with each hospital, provide status of enrollments and lead in Managers absence.

Education

• Associate degree and 2 years’ work-related experience in health care setting required.
• Professional billing experience preferred.

Experience

• 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

Pay Range: $24.00 - $30.00 per hr

Starting Pay: Based on Experience

Thompson Health is an EOE encouraging individuals with disabilities and veterans to apply.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.