Payor Enrollment Specialist

Saint Luke's Health System • Kansas City, MO

5d • Hybrid

About The Position

Saint Luke's Health System is a faith-based, not-for-profit aligned health system committed to the highest levels of excellence in providing health care and health-related services in a caring environment. We are dedicated to enhancing the physical, mental, and spiritual health of the diverse communities we serve. We offer competitive benefits, tremendous career growth, promotions from within, and the opportunity to transfer among hospitals and physician practices. If you share our commitment to excellence, we welcome you to apply. The Payor Enrollment Specialist will be responsible for creating and maintaining provider records in payor enrollment software, providing support and training to other personnel using payor enrollment software, completing online state provider enrollment applications (CAQH) for all providers, maintaining the CAQH attestation every 120 days, completing all provider specific documents for enrollment, promptly submitting practice and provider changes to the appropriate parties upon receipt, assisting with non-participation issues, maintaining the team email for enrollment correspondence, researching new provider specialties with payors to establish enrollment and maintains provider's enrollment status by coordinating revalidations for payors ever 2-3 years as required by manage care and government companies. This position requires an ability to correspond in a professional manner with providers to obtain confidential passwords, gaps in history, malpractice details, etc.

Requirements

• Minimum of 1 year prior experience specifically in payor enrollment or as a credentialing specialist required.
• Ability to correspond in a professional manner with providers to obtain confidential passwords, gaps in history, malpractice details, etc.

Responsibilities

• Creates and maintains provider records in payor enrollment software.
• Provides support and training to other personnel using payor enrollment software.
• Completes online state provider enrollment applications (CAQH) for all providers.
• Maintains the CAQH attestation every 120 days.
• Completes all provider specific documents for enrollment.
• Promptly submits practice and provider changes to the appropriate parties upon receipt.
• Assists with non-participation issues.
• Maintains the team email for enrollment correspondence.
• Researches new provider specialties with payors to establish enrollment.
• Maintains provider's enrollment status by coordinating revalidations for payors every 2-3 years as required by manage care and government companies.
• Provides support, assistance and guidance to other personnel regarding use of the payor enrollment software.
• Enters and keeps provider’s information current in payor enrollment software.
• Completes CAQH for all providers and maintains by attesting the accuracy of provider’s information every 120 days in accordance with CAQH requirements.
• Coordinate the initial enrollment and for managed care companies and government agencies.
• Provide customers with a status report of new providers.
• Prepares and updates insurance matrices.
• Review received payor enrollment forms for all information being complete and accurate, returns for corrections if necessary.
• Maintain provider’s enrollment status by coordinating revalidations for payors ever 2-3 years as required by manage care companies, Medicaid and Medicare.
• Maintain team email box for enrollment correspondence.
• Ability to navigate through Epic system to research account details.
• Process incoming mail and faxes.
• Ability to correspond in a professional manner with provider to obtain confidential passwords, gaps in history, malpractice details, etc.

Benefits

• Competitive benefits
• Tremendous career growth
• Promotions from within
• Opportunity to transfer among hospitals and physician practices
• Flex schedule working Monday -Friday between the hours of 6:00am-6:00pm (with a start time no later than 9am).
• Possibility to telecommute
• Career ladder advancement opportunities
• Bonus program

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed