Provider and Payer Enrollment Analyst- Full Time Days

Cape Fear Valley Health System; United States; On-site; USD 90,000 - 120,000; Full time

Job summary

Cape Fear Valley Medical Center in Fayetteville, NC is seeking a Physician Revenue Cycle professional to reduce delays affecting professional AR and support the CFV Medical Group and Provider Enrollment teams.

The role focuses on payer enrollment discrepancies, credentialing, workflow improvements, denial analysis, and coordinating with leadership to align Tax IDs and enterprise structure in Epic to ensure timely enrollment and cash flow.

Qualifications

• Education and Formal Training: Bachelor’s degree required OR 10 years collective experience in Physician Accounts Receivable, Provider Enrollment, Provider Onboarding, Managed Care Contracting and Medical Staff Services as well as payer-related duties relating to credentialing and enrollment required
• Work Experience: 5 years' experience required
• Knowledge, Skills, and Abilities Required: Proficiency in reading, writing, and speaking the English language
• Excellent interpersonal skills with the ability to interact with internal hospital department leadership as well as outside organizations
• Strong written and verbal skills, results oriented, and exemplify a team player attitude
• Expert skills in Microsoft Word, Excel, PowerPoint and Access or other software as required
• Willing and able to work on a variety of activities and projects
• Ability to work with people in a tactful, diplomatic manner
• Physical Requirements: Present a professional image
• Required Licenses and Certifications
• Cape Fear Valley Health System is an Equal Opportunity Employer M/F/Disability/Veteran/Sexual Orientation/Gender Identity

Responsibilities

• Assist the Physician Revenue Cycle, CFV Medical Group and Provider Enrollment teams by reducing delays impacting Professional AR
• Create Strategic Plan for AR resolution as it relates to credentialing and payer enrollment to help minimize impact on cash and create workflows to improve payer enrollment process
• Manage and oversee the release of providers and holding of providers in Epic to ensure timely resolution and denial reduction
• Identify areas for improvement while mitigating payment disruption
• Trend and provide denial analysis and share results to foster improvement and denial reduction
• Assist Director/PB Revenue Cycle, Managed Care leaders and Provider Enrollment manager on expanding delegated arrangements to expedite enrollment process and reduce delays and lag in enrollment process
• Align Individual Group Tax ID to corporate strategic structure and help establish controls to ensure that structure and integrity is maintained
• Other duties as assigned

Skills

AR Management

Payer Enrollment

Credentialing

Stakeholder Communication

Team Leadership

Education

Bachelor's degree or 10 years experience

Tools

Epic Systems

Microsoft Office (Word/Excel/PowerPoint/Access)

Job description

Facility Cape Fear Valley Medical Center Location Fayetteville, North Carolina Department Physician Financial Services Job Family Professional Work Shift Days (United States of America)

Summary Assist the Physician Revenue Cycle, CFV Medical Group and Provider Enrollment teams by reducing delays impacting Professional AR within CFV.

Major Job Functions

The following is a summary of the major essential functions of this job. The incumbent may perform other duties, both major and minor, that are not mentioned below. In addition, specific functions may change from time to time:

• Work with Physician Revenue Cycle on AR issues related to payer enrollment discrepancies and credentialing
• Create Strategic Plan for AR resolution as it relates to credentialing and payer enrollment to help minimize impact on cash and create workflows to improve payer enrollment process
• Manage and oversee the release of providers and holding of providers in Epic to ensure timely resolution and denial reduction
• Identify areas for improvement while mitigating payment disruption
• Trend and provide denial analysis and share results to foster improvement and denial reduction
• Assist Director/PB Revenue Cycle, Managed Care leaders and Provider Enrollment manager on expanding delegated arrangements to expedite enrollment process and reduce delays and lag in enrollment process
• Align Individual Group Tax ID to corporate strategic structure and help establish controls to ensure that structure and integrity is maintained

Other duties as assigned

Minimum Qualifications

• Education and Formal Training: Bachelor’s degree required OR in lieu of degree 10 years collective experience in Physician Accounts Receivable, Provider Enrollment, Provider Onboarding, Managed Care Contracting and Medical Staff Services as well as payer-related duties relating to credentialing and enrollment required
• Work Experience: 5 years' experience required
• Knowledge, Skills, and Abilities Required: Proficiency in reading, writing, and speaking the English language
• Excellent interpersonal skills with the ability to interact with internal hospital department leadership as well as outside organizations
• Strong written and verbal skills, results oriented, and exemplify a team player attitude
• Expert skills in Microsoft Word, Excel, PowerPoint and Access or other software as required
• Willing and able to work on a variety of activities and projects
• Ability to work with people in a tactful, diplomatic manner
• Physical Requirements: Present a professional image
• Required Licenses and Certifications
• Cape Fear Valley Health System is an Equal Opportunity Employer M/F/Disability/Veteran/Sexual Orientation/Gender Identity

For exceptional healthcare come to Cape Fear Valley Health where caring employees are committed to integrity, patient-centeredness and excellence throughout the entire healthcare process. At Cape Fear Valley Health, our goal is to improve the quality of every life we touch. Our diverse team of doctors, nurses and staff work together to create a better experience for every patient, every time.

Cape Fear Valley is a 950-bed, 8-hospital regional health system, the 8th largest in North Carolina, with more than 1 million inpatient and outpatients annually. A private not-for-profit organization with over 7,000 employees and 850 physicians. Our employees and physicians proudly serve a seven-county region of southeastern North Carolina, including Fayetteville, Fort Bragg, Hope Mills, Raeford, Lumberton, Elizabethtown, Clinton, Lillington, Dunn and beyond. Our medical facilities include Cape Fear Valley Medical Center, Highsmith-Rainey Specialty Hospital, Cape Fear Valley Rehabilitation Center, Behavioral Health Care, Bladen County Hospital, Hoke Hospital, Central Harnett Hospital, Betsy Johnson Hospital, as well as more than 60 medical offices and specialty care clinics spread throughout the Cape Fear region.