- Review and submit all third-party applications and perform necessary follow-up to obtain provider numbers on a timely basis.
- Maintain and update Enrollment databases and spreadsheets and ensure accuracy of information.
- Transmit provider enrollment information to data operations team for input into billing system.
- Run reports from Enrollment database for use by management and the clinical departments.
- Interact with University Hospital Managed Care Office to resolve managed care provider enrollment issues.
- Investigate and resolve billing issues related to enrollment.
- Scan provider files and paperwork into electronic storage system and ensure integrity of data.
- Act as resource to clinical department staff and providers utilizing the CPMP Enrollment Portal website.
- Complete ongoing Medicare and Medicaid revalidations to maintain active provider enrollment.
- Perform all other duties as assigned by management.
- High School diploma/GED.
- 3 years progressive clerical experience in a Healthcare setting.
- Proficient in Microsoft Word and Excel.
- Familiarity with professional licensing and education documents.
- Must have excellent expressive and written communication skills.
- Must be highly organized and able to multi-task.
- Associate's degree.
- MCR/MCD provider enrollment experience.
- Athena/IDX knowledge helpful.
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Enrollment Specialist - East Setauket, United States - SB Clinical Practice Management
Description
OverviewEnrollment Specialist - Stony Brook CPMP Patient Accounts
Location: East Setauket, NY; At the manager's discretion, this role may be eligible for remote work; this position is only available to New York State Residents.
Schedule: Full time
Days/Hours: Monday - Friday; 8:30 AM - 5 PM
Pay: $ $26.13
Our compensation philosophy aims to provide marketable compensation programs and to compensate employees based on relevant experience and education. Individual compensation discussions begin during the hiring process and may occur during job review and promotional opportunities. Salaries vary depending on experience, education and current market for the position. Human Resources determines the external and internal equitable salary for each employee.
Responsibilities
SUMMARY: The Enrollment Specialist's primary responsibilities will be to work with clinical Department personnel to process new and terminating Physician and Advanced Practice provider applications and paperwork, to follow-up with third party carriers to obtain provider numbers and to maintain Enrollment databases, website and spreadsheets.
Job Duties & Essential Functions:
Required Qualifications:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to communicate with patients, staff and medical providers. The employee must be able to exchange accurate information in these situations. This position is largely sedentary and requires the employee to remain stationary for a majority of the day. Any additional physical demands will be outlined and provided by management.
The responsibilities and tasks outlined in this job description are not exhaustive and may change as determined by the needs of CPMP.
StaffCo is a Professional Employer Organization, commonly referred to as a PEO, duly organized and registered under the New York Professional Employer Organization law. StaffCo and SUNY have entered into a professional employer agreement under which StaffCo is the employer of Stony Brook Clinical Practice Management Plan employees and responsible for all aspects of employment, including hirings, promotions, disciplines, terminations, the day-to-day direction and supervision of work, as well as labor relations and collective bargaining. StaffCo is fully responsible for providing all payroll and human resources services, including the payment of wages, collecting and reporting payroll taxes and maintaining any and all employee benefits. SUNY Stony Brook Hospital is responsible for the operation of the hospital and provision of health care and is the co-employer as is necessary to conduct its responsibilities and for related licensure, regulatory or statutory requirements and obligations.
Given StaffCo's employment responsibilities, it is deemed the "employer" for employment and labor law purposes. Thus, the employees are private sector employees of StaffCo, not public sector employees of SUNY. The private sector nature of the StaffCo employees has been approved by NYS Civil Service and upheld in a decision by the US National Labor Relations Board.
CPMP provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, gender identity or expression, or any other legally protected status. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall and transfer, leaves of absence, compensation and training.
CPMP expressly prohibits any form of workplace harassment based on race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, gender identity, or any other legally protected status. Improper interference with the ability of CPMP's employees to perform their job duties may result in discipline up to and including discharge.
