PAYER ENROLLMENT ANALYST

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

Job summary

UR Thompson Health is seeking a Payer Enrollment Coordinator to manage initial applications for third-party payer enrollment for the Southern Region (6 hospitals/5 health systems). The role is onsite in Canandaigua, NY, and involves submitting applications, maintaining CAQH files, and coordinating with IT and payer networks.

Requires an Associate degree and 2 years of healthcare experience; billing experience preferred. Starting pay is $24.00–$30.00 per hour, with pay based on experience.

Qualifications

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

Responsibilities

• Coordinate initial applications for third party payer enrollment for all Southern Region billing Providers (6 hospitals/5 health systems)
• Coordinate submission of signed applications to third party payers for enrollment for all Southern Region billing Providers (6 hospitals/5 health systems)
• Complete and submit all provider changes to payers as required
• Act as liaison to payer enrollment, IT and Credential Stream to develop enrollment workflows
• Complete recertifications/revalidations for third party payers
• Maintain CAQH files including re-attestations and uploading required data
• Perform revalidations for providers as required by CMS and payers
• Communicate with third-party payers to establish new practice locations including CMS
• Submit required documentation to payers upon termination of provider
• Maintain workflows to ensure enrollment completion for every payer/provider requested

Skills

Customer relations

Communication skills

Excel

Word

SharePoint

Teams

Box

Internet usage

Education

Associate degree

2 years' healthcare experience

Professional billing experience

Tools

Excel

Word

Box

Teams

SharePoint

Internet usage

Job description

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

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

Main Function

• 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
• Excellent Attention to detail
• Pay Range:** $24.00 - $30.00/hr
• Starting Pay:** Based on Experience
• _Thompson Health is an EOE encouraging individuals with disabilities and veterans to apply._**