Payer Enrollment Specialist
Payer Enrollment Specialist
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Job Description
Job Title: Payer Enrollment Specialist
Location: Norwood OH 45212
Position Details:
- Duration: 13week contract
- Start Date: October 21 2024
- Shift: 7:00 AM 4:00 PM 3240 hours per week
- Location: Fully onsite (remote work is not available)
- Dress Code: Business casual
Job Summary: The Payer Enrollment Specialist is responsible for credentialing physicians and allied health providers in a health system or hospital setting. The role involves ensuring the accuracy and timely submission of provider applications maintaining provider databases and communicating with relevant stakeholders such as TCHMA Administration Billing and Office Managers. This position plays a critical role in supporting the enrollment and recredentialing processes with managed care organizations government agencies and other payers.
Responsibility:
- Accurately complete and review provider applications for enrollment.
- Contact healthcare providers government agencies and managed care companies to gather missing application information verify statuses and resolve discrepancies.
- Ensure the timely submission of reappointments and recredentialing documents ensuring licenses and certifications are current.
- Maintain and update internal files including copies of current credentials and provider information.
- Regularly update and manage the CAQH database to ensure accurate information for all enrolled providers.
- Collaborate with TCHMA Administration Billing Department and Office Managers for communication and followup.
- Perform other related duties as assigned.
Skills & Experience:
- 5 years of experience in payer enrollment within a health system or hospital setting.
- Strong knowledge of CAQH (Council for Affordable Quality Healthcare).
- Proficient in Microsoft Excel for data management and reporting.
- Experience using Cactus/Symplr credentialing software.
- Excellent attention to detail and accuracy in managing credentialing processes.
- Must have prior experience working in a hospital system.
- Ability to work in a fastpaced environment adaptable to change and work under pressure.
Preferred:
- Cactus/Symplr and CAQH experience highly preferred.
Note: Candidates with nursing allied health or agency credentialing experience will not be considered.
Education:
- Required: High School Diploma or equivalent.
- Preferred: Some college education is preferred (degree not required).
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Employment Type
Full Time
