Payor Enrollment Specialist

2 months ago

Phoenix, United States HonorHealth Full time

Overview:

  • Experience in Health PlanCredentialing
  • General Idea of Enrollment
  • Experience in Healthcare
  • Fully- On-Site
  • Hours of Operation: 8am-4:30pm- Monday-Friday

Looking to be part of something more meaningful? At HonorHealth, youll be part of a team, creating a multi-dimensional care experience for our patients. Youll have opportunities to make a difference. From our Ambassador Movement to our robust training and development programs, you can select where and how you want to make an impact.

HonorHealth offers a diverse benefits portfolio for our full-time and part-time team members designed to help you and your family live your best lives. Visit honorhealth.com/benefits to learn more.

Join us. Lets go beyond expectations and transform healthcare together.

HonorHealth is one of Arizonas largest nonprofit healthcare systems, serving a population of five million people in the greater Phoenix metropolitan area. The comprehensive network encompasses six acute-care hospitals, an extensive medical group with primary, specialty and urgent care services, a cancer care network, outpatient surgery centers, clinical research, medical education, a foundation, an accountable care organization, community services and more. With nearly 14,000 team members, 3,700 affiliated providers and hundreds of volunteers dedicated to providing high quality care, HonorHealth strives to go beyond the expectations of a traditional healthcare system to improve the health and well-being of communities across Arizona. Learn more at HonorHealth.com.

Qualifications:
Education
High School Diploma or GED Required

Experience
2 years credentialing, payor enrollment, medical staff or administrative assistant including data entry, in a hospital or healthcare environment. Required

Responsibilities:
Job Summary
The Payor Enrollment Specialist is responsible for providing enrollment and payor credentialing information to insurance and health plans to support the processing of payor applications and reapplications. Provides enrollment support to the centralized appointment and reappointment process including reports and obtaining required data from the health plans and appropriate internal departments, in accordance with all appropriate regulatory agencies standards
  • Provides payor enrollment and credentialing support to the credentialing manager. Maintains a sound working knowledge of payor enrollment, payor credentialing and provides consultation regarding payor enrollment and credentialing, to ensure all processes are in compliance with state statutes and regulatory agencies as demonstrated by observation.
  • Responsible for timely processing of health plan initial applications and reappointment applications for completeness and in accordance with appropriate standards. Communicates with health plans during enrollment process to ensure timely and expeditious completion of process. Researches incidents, submission of applications for timely processing and uploading to payors, maintains accurate effective dates and request appropriate follow-up information from payors or other sources as indicated. May be responsible for gathering information and perform research in contract disputes between health plans and providers.
  • Maintains the payor enrollment and credentialing database for physician and faculty. Ensures data is accurately entered as evidenced by audit. Prepares reports in compliance with requests for information as demonstrated by documentation.
  • Maintains adherence to professional confidentiality standards established within the Department and in accordance with legal, ethical and hospital, payor enrollment and credentialing, and medical staff policies. Assures data security and confidentiality by use of appropriate labeling of information and storage, and appropriately securing cabinets and drawers.
  • Performs other duties as assigned.


Facility:
Support Services

Department:
Cred/Med Staff Srvcs

Work Hours:
M-F 8am-4:30pm

Shift:
01 - Days

Position Type:
Regular Full-Time

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