Payer Enrollment Analyst

UR Medicine Thompson Health; Town of Canandaigua (NY); Vor Ort; USD 33.000 - 41.000; Vollzeit

Zusammenfassung

UR Medicine Thompson Health is seeking a Payer Enrollment Analyst to coordinate enrollment applications with regional hospitals and payers. You will liaise with providers, IT, and payer systems to ensure timely, accurate credentialing and ongoing revalidations across the Southern Region.

The role requires an Associate degree and 2 years in healthcare billing, with strong Excel/SharePoint skills and familiarity with payer enrollment workflows. The position is onsite in New York.

Qualifikationen

• Associate degree required with 2 years in health care setting.
• Professional billing experience preferred.
• Experience with payer enrollment processes is a plus.

Aufgaben

• 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).
• 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.
• Maintains workflows to ensure enrollment completion for every payer/provider requested.

Kenntnisse

Customer relations

Communication skills

Computer literacy

Third-party payers knowledge

Ausbildung

Associate degree

Tools

Excel

Word

Box

Teams

SharePoint

Internet

Jobbeschreibung

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/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.