- Collect and maintain providers' credentials and supporting documentation for the purpose of enrolling individual providers with payers.
- Maintain CAQH electronic database of provider information and credentials. Work with enrolled providers to ensure ongoing attestations are completed in a timely manner.
- Maintain good rapport and professional communication with all providers, Credentialing Specialist, internal stakeholders, and Health Plan Representatives.
- Ensure all providers are credentialed with insurance companies at all times to allow for maximum reimbursement of services rendered, to include completing all insurance company/contract forms related to provider credentialing and submits in a timely manner; tracks and follow up on all credentialing applications to ensure timely processing; communicate status to management staff.
- Update participating provider list, including supervisory changes, on an ongoing basis to ensure accuracy in billing and scheduling.
- Fully remote In Eastern Standard Time only
- High school diploma or equivalent
- Minimum of 2 years of experience in healthcare payer enrollment/physician billing
- Experience with Federally Qualified Health Center (FQHC) billing and credentialing processes.
- Strong attention to detail and ability to manage multiple tasks simultaneously and independently
- Excellent communication and interpersonal skills
- Working knowledge of EPIC and/or Credential Stream preferred
- Experience with the Medicare PECOS system preferred
- All employees at UCFS are required to be vaccinated against COVID-19
- Flexible schedules
- Competitive salaries
- Generous paid time off including 3 weeks vacation, 5 floating holidays and 10 sick days each year
- Medical, dental and vision insurance
- 401(k) plan with 6% employer contribution
- Paid life and disability insurance
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Payer Enrollment Specialist - Norwich, United States - United Community & Family Services, Inc.
Description
Job Type
Full-time
Description
Be part of a team where you can advance your clinical skills, make vital connections, and become an advocate for your clients and the community. You will have opportunities to cultivate and enhance your clinical skills through individual and group supervision, in-house training, and outside training. Our team is passionate about the services we provide and is committed to making a difference, while striving to become more culturally competent and affirming each day. At UCFS, a Federally Qualified Health Center, we specialize in integrated care which means having access to essential services to meet the complex needs of those we serve. We work collaboratively across programs at our agency to remove barriers and streamline access to services including behavioral health services, primary care, dental, case management and more.
We are seeking a highly motivated and detail-oriented Payer Enrollment Specialist to join our team. The ideal candidate
is responsible for the insurance enrollment and credentialing process for all new and established providers, and maintenance of information to include application completion, follow up, setup in participating insurance contracts. Looking for someone who has thorough knowledge and is proficient in all aspects of payer and provider enrollment in a professional healthcare practice setting. Experienced with the payer enrollment application process for commercial, government, and managed care contracts. Working knowledge of FQHC regulations is preferred. The focus will be, but not limited to, provider and facility enrollment with all contracted payers from start to finish for new and established providers and other licensed staff.
Requirements
