Provider and Payer Enrollment Analyst- Full Time Days

Cape Fear Valley Health

6d

About The Position

The Provider and Payer Enrollment Analyst assists Physician Revenue Cycle, CFV Medical Group, and Provider Enrollment teams by reducing delays that affect professional accounts receivable within CFV. The role works with Physician Revenue Cycle to address AR issues related to payer enrollment discrepancies and credentialing, and develops strategic plans and workflows to resolve related AR issues, minimize cash impact, and improve the payer enrollment process.

The analyst manages provider releases and holds in Epic to support timely resolution and reduce denials, identifies improvement opportunities while mitigating payment disruptions, and analyzes denial trends to share results and foster improvement. The position also assists revenue cycle, managed care, and provider enrollment leaders with expanding delegated arrangements, and aligns individual group tax IDs with the corporate strategic structure while helping establish controls to maintain its integrity. Other duties may be assigned.

Requirements

• Bachelor’s degree, or in lieu of a degree, 10 years of collective experience in Physician Accounts Receivable, Provider Enrollment, Provider Onboarding, Managed Care Contracting, and Medical Staff Services, including payer-related credentialing and enrollment duties.
• Five years of experience required.
• Proficiency in reading, writing, and speaking English.
• Excellent interpersonal skills and ability to interact with internal hospital department leadership and outside organizations.
• Strong written and verbal communication skills; results-oriented and a team-player attitude.
• Expert skills in Microsoft Word, Excel, PowerPoint, and Access, or other software as required.
• Willingness and ability to work on a variety of activities and projects.
• Ability to work with people in a tactful, diplomatic manner.
• Ability to present a professional image.

Responsibilities

• Work with Physician Revenue Cycle on AR issues related to payer enrollment discrepancies and credentialing.
• Create strategic plans for AR resolution related to credentialing and payer enrollment to minimize cash impact and develop workflows that improve the payer enrollment process.
• Manage and oversee provider releases and holds in Epic to ensure timely resolution and reduce denials.
• Identify areas for improvement while mitigating payment disruption.
• Trend and provide denial analysis and share results to foster improvement and denial reduction.
• Assist the Director/PB Revenue Cycle, Managed Care leaders, and Provider Enrollment manager with expanding delegated arrangements to expedite enrollment and reduce delays.
• Align individual group tax IDs to the corporate strategic structure and help establish controls to maintain that structure and its integrity.
• Perform other duties as assigned.

What This Job Offers

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