Revenue Cycle Payer Enrollment Specialist (FT- 1.0 FTE, Day Shift, Remote Possible)

Bozeman Health

2d•Remote

About The Position

The Revenue Cycle Enrollment Specialist coordinates, completes and monitors the provider/facility payer credentialing process. Processes credentialing and re-credentialing applications for health care providers. Sends, reviews, and verifies credentialing applications. Loads and maintains provider information in an online credentialing database system. Tracks license and certification expirations for medical staff to ensure timely renewals. Handles and resolves inquiries regarding credentialing information, process, or status.

Requirements

Associate’s degree; equivalent combination of education and experience will be considered
Current Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Staff Management (CPMSM) by the National Association of Medical Staff Services (NAMSS) or obtained within two (2) years of hire
Two (2) years of healthcare experience
Demonstrates sound judgment, patience, and maintains a professional demeanor at all times
Exercises tact, discretion, sensitivity, and maintains confidentiality
Performs essential job functions successfully in a busy and stressful environment
Learns current and new computer applications and office equipment utilized at Bozeman Health
Strong interpersonal, verbal, and written communication skills
Analyzes, organizes, and prioritizes work while meeting multiple deadlines
Works varied shifts as scheduled and/or needed
This role requires regular and sustained attendance.
The position may necessitate working beyond a standard 40-hour workweek, including weekends and after-hours shifts.
On-call work may be required to respond promptly to organizational, patient, or employee needs.
Sit (Continuously): Maintaining a sitting posture for extended periods may include adjusting body position to prevent discomfort or strain.
Fine-Finger Movements (Continuously): Picking, pinching, typing, or otherwise working primarily with fingers rather than using the whole hand as in handling.
Vision (Continuously): Close visual acuity to prepare and analyze data and figures and to read computer screens, printed materials, and handwritten materials.
Cognitive Skills (Continuously): Learn new tasks, remember processes, maintain focus, complete tasks independently, and make timely decisions in the context of a workflow.

Nice To Haves

One (1) year of payer credentialing experience

Responsibilities

Collect, review, and prepare data for final medical staff and allied health professionals “Providers” credentials review for the clinic, hospital, and payer environments and Bozeman Health “Facility” payer enrollments.
Work with Providers and department leaders to obtain any missing information.
Process requests for additions or changes in payer enrollment.
Ensure that requisite licenses, malpractice coverage, and certifications are current for all Providers and Facilities.
Perform delegated credentialing for all applicable payers and supplies applicable payers with timely provider rosters.
Maintain files on Providers and Facilities, including information related to licensure or clinical practice disciplinary actions, clinical practice restrictions, and medical malpractice suits, judgments, and settlements.
Provide requested reports as directed.
Maintain current knowledge of and compliance with medical staff accreditation standards with applicable regulatory agencies and licensing standards.
Participate in the development and implementation of credentialing policies and procedures.
Manage payer response to re-validation for Provider and Facility enrollments to avoid any lapse in enrollment.
Provides concise, timely communication to appropriate leadership regarding potential credentialing issues.