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

Valley Health System•Blacksburg, VA

10d•$74,214 - $92,768•Onsite

About The Position

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.

Requirements

College degree required.
3 or more years in provider enrollment and/or payer credentialing required.
Strong Excel skills required.
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.

Responsibilities

Manages and monitors payor enrollment activities for VMG.
Handles initial enrollment and re-credentialing of medical group providers into governmental and managed care plans.
Initiates enrollment applications and provider re-validation.
Maintains payer rosters and provides payer credentialing support.
Performs provider data activities with providers, payers, medical staff office, and delegated credentialing partners.
Maintains Provider Enrollment data integrity, including auditing and maintaining provider/payer rosters.
Serves as a subject matter expert for provider enrollment processes and payer requirements.
Identifies and resolves routine enrollment, roster, and data issues.
Maintains provider enrollment data integrity across applicable systems and payer portals.
Provides reporting and information to support the Department Manager's oversight of provider enrollment, credentialing, and payer-related operational activities.

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