Payor Enrollment Specialist

Midland Health•Midland, TX

1d•Onsite

About The Position

A Payor Enrollment Specialist is responsible for provider enrollment into Federal, State, and commercial health plans. The enrollment process begins with gathering provider data needed for enrollment and completion of provider applications. A Payer Enrollment Specialist also advises the provider’s office concerning best practices and procedures pertaining to enrollment. Regular correspondence and follow-up with provider’s office and health plans is essential until provider is fully enrolled.

Requirements

Experience in Payor/Provider Enrollment or Credentialing required.
Minimum of 2 years of college experience or directly applicable experience in payor enrollment required.
Experience with Microsoft Office Suite including Word, Excel and Teams.

Responsibilities

Communicate and advise designated contact person of the paperwork necessary to begin the application process for new providers, including any necessary research to gather all details to appropriately enroll provider.
Communicate and advise the provider or designated contact person of the sequential steps needed to begin the enrollment process through completion and set timeline expectations.
Maintain contact with designated contact person to obtain application signatures and collect all required documents to include with the completed applications.
Key all provider demographics & enrollment data into software system.
Scan all related enrollment documents and applications into software system.
Contact health plans to request provider enrollment application packages and/or required action for enrollment and continue follow-up with insurance plans by telephone or email until all provider numbers are issued.
Prepare and distribute Payor Affiliation Reports and Status Notes to designated contact person(s) for each provider every 2-3 weeks in order to communicate the progress of approved provider numbers.
Prepare and submit monthly invoices in accounting software showing new work and completed work.
Ability to interact positively in a team environment, demonstrating superior teamwork skills.
Ability to manage assigned projects individually, without supervision and make independent decisions.
Superior attention to detail and organization skills
Excellent time management skills, resource organization and priority establishment skills, and ability to multi-task in a fast-paced environment.
Ability to effectively interface and communicate, both written and verbal, with all levels inside and outside the company.
Any other assigned responsibilities as requested by Supervisor, not specifically noted above.