Payor Enrollment Data Specialist, Financial Admin, Full Time, Day

Valley Health System; Paramus (NJ); On-site; USD 74,000 - 93,000; Full time

Benefits offered by this job

Medical / Vision discount

Life Insurance

FSA & Commuter

Disability insurance (short/long)

Paid holidays & PTO

Retirement plan

Tuition assistance

EAP

Fitness center discounts

Day care discounts

Job summary

Valley Health System is seeking a Payor Enrollment Specialist to manage and monitor enrollment activities for VMG, including initial enrollment and re-credentialing of providers with governmental and managed care plans. You will coordinate with providers, payers, the medical staff office, and credentialing partners to ensure data integrity and timely processing.

Responsibilities include initiating enrollment applications, performing provider re-validation, maintaining payer rosters, and

Qualifications

• College degree required.
• 3+ years in provider enrollment or payer credentialing.
• Strong Excel skills required.

Responsibilities

• Manage and monitor payor enrollment activities for VMG, including initial enrollment and re-credentialing of providers into governmental and managed care plans.
• Initiate enrollment applications, provider re-validation, payer roster maintenance and credentialing support with providers, payers, medical staff office and delegated credentialing partners.
• Maintain Provider Enrollment data integrity including auditing and roster maintenance across systems and payer portals.
• Provide reporting and information to support the Department Manager's oversight of enrollment, credentialing and payer-related operational activities.

Skills

Interpersonal skills

Analytical skills

Communication skills

Organizational skills

Time management

Independence & teamwork

Problem-solving

Judgment

Education

College degree

Tools

Excel

Job description

Position Summary

This position manages and monitors the payor enrollment activities for VMG, including the initial enrollment and re-credentialing of all medical group providers into governmental and managed care plans. Duties include, but are not limited to, initiating the enrollment application, provider re-validation, payer roster maintenance, payer credentialing support and related provider data activities with provider, payers, medical staff office and delegated credentialing partners. Position is responsible for maintaining Provider Enrollment data integrity including auditing and maintaining provider/payer roster. The position serves as a subject matter resource for provider enrollment processes and payer requirements and is responsible for identifying and resolving routine enrollment, roster and data issues. The position maintains provider enrollment data integrity across applicable systems and payer portals and provides reporting and information to support the Department Manager's oversight of provider enrollment, credentialing and payer-related operational activities.

Education

College degree required.

Experience

• 3 or more years in provider enrollment and/or payer credentialing required.


• Strong Excel skills required.

Skills

• Strong interpersonal skills with the ability to build and maintain effective working relationships with diverse internal and external stakeholders, including physicians, payers, administrators, and multidisciplinary teams.


• Advanced analytical and data analysis skills with the ability to evaluate complex information, identify trends, and support informed decision-making.


• Excellent written and verbal communication skills, including the ability to clearly convey information to various audiences.


• Strong organizational and time management skills with exceptional attention to detail.


• Ability to manage multiple priorities simultaneously and effectively balance competing deadlines in a fast-paced environment.


• Demonstrated self-confidence, initiative, and ability to work independently while collaborating effectively within a team environment.


• Proven problem-solving and critical-thinking skills with a focus on accuracy and results.


• Ability to exercise sound judgment and maintain professionalism when interacting with stakeholders at all levels of the organization.

Job Location

Kraft Center

Shift

Day (United States of America)

Benefits

• Medical/Prescription, Dental & Vision Discount Program (Full Time/Part Time Employees)


• Group Term Life Insurance and AD&D(Full Time Employees)


• Flexible Spending Accounts and Commuter Benefit Plans


• Supplemental Voluntary Benefits ( e.g. Short-term and Long-term Disability, Whole Life Insurance, Legal Support, etc.)


• 6 Paid Holidays, Paid Time Off (varies), Wellness Time Off, Extended Illness


• Retirement Plan


• Tuition Assistance


• Employee Assistance Program (EAP)


• Valley Health LifeStyles Fitness Center Membership Discount


• Day Care Discounts for Various Daycare Facilities

Salary

Joining Valley Health System means becoming part of a dedicated team that values the highest quality of care in a supportive environment. In our commitment to high performance and reliability, we encourage and recognize exceptional individual performance through our industry leading compensation practices including a starting salary and benefits in accordance with your role, experience, education, and licensure. Actual individual salaries vary depending on these factors. The salary listed does not include other forms of compensation or benefits.

Pay Range: $74,214.40 - $92,768.00

The posted pay range reflects the compensation for a full-time equivalent (1.0 FTE)

EEO Statement

Valley Health System does not discriminate on the basis of ancestry, age, atypical hereditary cellular or blood trait, civil union status, color, creed, disability, domestic partnership, gender, gender identity or expression, familial status, genetic information, liability for service in the Armed Forces of the United States, marital status, medical condition or illness, mental or physical handicap, national origin, nationality, perceived disability, pregnancy, race, refusal to submit to genetic testing or make available results of such tests, religion, sex, sexual orientation, veteran’s status or any other protected basis, in accordance with all applicable Federal, State and Local laws. This applies to all areas of employment, including recruitment, hiring, training and development, promotion, transfer, termination, layoff, compensation, benefits, social and recreational programs, and all other conditions and privileges of employment.