Enrollment Specialist Government Payers - Remote Position

Beth Israel Lahey Health

26d • $21 - $33 • Remote

About The Position

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives. Under the direction of the Manager, Provider Enrollment and Reporting, the government payer Enrollment Specialist is responsible for the enrollment of both individual providers and groups/locations with non-commercial payers (Medicare, Medicaid). Job Description: The provider enrollment process ensures that the appropriate provider enrollment numbers are obtained for both individual providers and groups/locations enabling the organization to bill provider charges in a timely manner and ensure clinicians have the ability to order, refer, and prescribe as necessary. This includes initiating the enrollment process from notification that a new individual providers or groups/locations will be added to the network and collaborating with multi-disciplinary on-boarding group and the practitioner to complete the application process. The position also includes responsibility for ensuring that the re-verification process and any interim or re-credentialing activities required by government payers occurs to ensure continuous, uninterrupted participation status for all both individual providers and groups/locations. This position maintains up to date and thorough knowledge of non-commercial payer enrollment obligations at the State and Federal level.

Requirements

• Bachelor's Degree or equivalent education and experience.
• Minimum of 2-3 years experience in non-commercial payer enrollment.
• Provider enrollment technical proficiency, effective and professional communication skills.

Nice To Haves

• CPCS or PESC Certification preferred but not required

Responsibilities

• Completes the government payer enrollment process for all new individual providers and groups/locations within established timeframes.
• Obtains information needed for government payer application process from individual providers as well as leveraging information on file, already available within Medical Staff Administration and/or network development staff.
• Completes maintenance updates and re-verification/re-validation for all both individual providers and groups/locations within established timeframes.
• Maintains and updates data on both individual providers and groups/locations including, but not limited to name changes, office location and demographic changes, linking practitioners to new groups, TINs.
• Responsible for populating and updating various databases, internal and external, to accurately reflect non-commercial (government) payer participation and related data.
• Prior to each Credentials Committee meeting or approval of applicants by the Credentials Committee; submits enrollment applications to appropriate state(s) Medicare/Medicaid programs.
• Prior to opening or acquisition of groups/locations submits enrollment applications to appropriate state(s) Medicare/Medicaid programs.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level