Provider Enrollment & HR Analyst

BestSelf Behavioral Health•Buffalo, NY

50d•$25 - $29•Onsite

About The Position

The Provider Enrollment & HR Analyst is responsible for preparing and submitting applications and supporting documentation for the purpose of enrolling individual physicians and physician groups with payers. The Provider Enrollment & HR Analyst also processes new applications, revalidations, and updates roster, performs confidential administrative tasks associated with the human resource management of the agency. The Provider Enrollment & HR Analyst will maintain HR files in accordance with all mandating guidelines. Builds and runs reports on an as needed basis. Works with multidisciplinary team to develop, track, and monitor quality & compliance indicators, staff in-services, mandatory and elective trainings, and quality improvement information.

Requirements

Bachelor's degree in Business or Human Resources and 2 years of HR related experience - OR- Associate's degree in Business or Human Resources and 4 years of HR related experience
PLUS 2 years of experience with processing the full Provider Enrollment cycle.
Strong knowledge working with report writing databases as well as common office technology/software including the use of the Microsoft Office Suite.
Ability to maintain confidentiality
Excellent communication skills with all levels of staff
Efficient time management
High attention to detail
Understanding of the agency's programs and services
Experience working with and full understanding of insurance carriers' processes.
Familiarity with NCQA standards and how to apply them.
Proficient with basic computer systems, networks, and software applications, such as the Microsoft Office Suite (Outlook, Word, and Excel).

Responsibilities

Maintain updated knowledge of Provider Enrollment regulations and develop new/update existing procedure documentation.
Collaborate with insurance carriers to ensure the team is enrolling new BestSelf programs by following the applicable requirements and enrollment procedures.
Investigate new external electronic platforms used by insurance carriers and ensure the team is prepared to utilize efficiently and effectively.
Receive and analyze all verified documentation for Providers and execute provider enrollment with carriers.
Process new enrollments, revalidations, and making sure all providers are linked with their appropriate sites.
Shares essential updates with providers and internal teams as necessary in weekly summary reports or other correspondence.
Collaborate with the Billing team on enrollment issues to investigate and correct.
Work closely and effectively with the Insurance Carriers and Providers.
Correspond with providers and Program Directors as necessary.
Establish a relationship with the carrier credentialing representative and keep up on any changes or updates with the carriers.
Communicate with providers on any enrollment issues, needs and updates.
Update Providers CAQH accounts.
Runs various audit reports on a determined frequency from the HRMS to ensure employee data and file documentation is compliant.
Provide reports to HR management team, SMT and/or EMT as requested by the Talent Acquisition and HRIS Manager.
Protects employee data by maintaining access rights to our employee databases and documents.
Assists the Talent Acquisition & HRIS Manager in confidential tasks associated with Human Resource management of the agency.
Enters, updates, and verifies data in HRMS as directed.
Works closely with the other branches within the agency to provide a seamless employee experience as it relates to their career, wages, and benefits.
Serve as a liaison between the agency and our HR systems in developing new processes and resolving any technology issues that may arise.
Using state and national web sites, monitors license and other sanctions monthly.
Develops and maintains mechanisms to track agency wide audit information, such as excel spread sheets and HR software.
Promote agency's Racial Equity and Inclusion concepts.
Builds and maintains an effective, professional, and positive working relationship with all levels of employees
Provides timely, caring, and thorough employee service when employee inquiries are received.
Provide support and guidance to the HRIS and Talent Acquisition teams as needed and as requested.
Maintain confidentially and containment with to remain in compliance with HIPAA and protect employee information at all times.
Completes all trainings required by the agency.
Performs all other duties as assigned.