Senior Payor Enrollment Assistant
United States
Full Time
1 hour ago
$38,937 - $52,686 USD
No H1B
About this role
Role Overview
- Manages daily provider enrollment, maintaining and communicating enrollment data
- Populating MD Staff
- Ensuring provider files meet managed care criteria
- Submitting rosters to delegated payors
- Completing CAQH applications for non-delegated payors
- Processing data updates/terms
- Following up with payors for timely loading
- Managing MD Staff payor enrollment/EPriv
- Running delegated audit rosters
- Enrolling/re-validating Medicare/Medicaid
- Completing non-Ascension hospital privileges
- Creating/auditing the provider database
- Communicates policy changes and stays current on regulatory issues
Requirements
- High School diploma equivalency OR 1 year of applicable cumulative job specific experience required
- 2 years of Health Plan delegation
- Comprehensive knowledge of Delegated Credentialing, spanning process, regulatory requirements, and best practices, a must have
- Strong regulatory knowledge of EPriv, NCQA, URAC, and CMS required
Benefits
- Paid time off (PTO)
- Various health insurance options & wellness plans
- Retirement benefits including employer match plans
- Long-term & short-term disability
- Employee assistance programs (EAP)
- Parental leave & adoption assistance
- Tuition reimbursement