Provider Enrollment Specialist Senior - HP Enrollment Eligibility

Summary:

This role serves as a Payer Enrollment liaison. Represents Payer Enrollment on matrix calls. Collaborates with Credentialing team and local operations to ensure timely payer enrollment.

Coordinates Medicare and Medicaid enrollment/re-enrollment as well as commercial payer credentialing and enrollment Maintains NPI files and provider numbers. Serves as customer service liaison. Interacts with providers, Operation leaders, insurance carriers, and practice personnel concerning payer enrollment. Performs all functions in a courteous and professional manner.

Responsibilities:

• Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
• Collaborates with CBO and local operations on enrollment related issues.
• Attends and provides enrollment related updates on matrix calls.
• Collaborates with Credentialing Team and local operations on items needed.
• Updates Credentialing/Payer Enrollment database as needed.
• Accesses payer databases as needed to ensure appropriate enrollment.
• Performs multi-state Medicaid Enrollment through state portals.
• Submits updates as needed to payers.
• Maintains internal enrollment database.
• Educates associates on enrollment processes when needed.
• Performs required tasks of Delegated Payers as needed.
• Prepares and submits applications/or required documents to Payers for new provider
• enrollments and existing provider updates.
• Collects and maintains data on providers for Medicare and Medicaid enrollment.
• Communicates with provider to perform multi-factor-authentication process as needed.
• Complies with Medicare and Medicaid provider enrollment guidelines.
• Communicates information to appropriate personnel.
• Participates in company sponsored enrollment/credentialing meetings and other
• educational activities.
• Follows the Health Insurance Portabillity and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of PHI.
• Maintains strict confidentiality.
• Uses oral and written communication skills to effectively convey ideas in a clear, positive manner that is consistent with the CHRISTUS Mission
• Maintains established CHRISTUS policies, procedures, objectives, quality assurance, safety, environmental and infection control.
• Implements job responsibilities in a manner that is consistent with the CHRISTUS mission, code of ethics and is supportive of the cultural diversity objectives.
• Performs other work as required.

Job Requirements:

Education/Skills

• High school diploma or equivalent required

Experience

• 3-5 years of Payer Enrollment experience preferred
• Solid knowledge and utilization of PC applications including Microsoft Word and Excel
• Excellent written and verbal communication skills
• Excellent organization and planning skills with demonstrated teamwork skills
• Proven ability to interact with all levels of management and other Associates

Licenses, Registrations, or Certifications

• None required

In accordance with the CHRISTUS Health License, Certification and Registration Verification Policy, all Associates are required to obtain the required certifications for their respective positions within the designated time frame.

Work Schedule:

5 Days - 8 Hours

Work Type:

Full Time