Payer Enrollment Specialist

1 day ago


Melville, New York, United States Catholic Health Service Full time

Job Summary

Catholic Health Service is seeking a highly skilled Payer Enrollment Coordinator to join our team. The successful candidate will work closely with our physician partners to ensure timely and accurate physician contracting. This role is responsible for coordinating the transition of physician payer enrollment to the IPA, interacting with Business Development, Provider Relations, insurance companies, and physician offices to effectively enroll providers in CHSPP contracts, and mitigating claims issues as needed.

Key Responsibilities

Serve as liaison between Practice Administrators and/or Billing Managers and insurance carriers
Respond to requests for information and telephone inquiries from Provider and insurance carriers
Assist in the training of new and temporary staff
Work with the insurance carriers to investigate, research, track, resolve, and communicate claims issues related to payment and contractual rates
Submit monthly rosters to payers to add/update the physician network
Update physician practice demographic information and payer plan information in Salesforce
Perform quality control in Salesforce and other applicable databases to ensure it reflects updated provider insurance plan information accurately and timely
Diagnose and solve root causes around missing effective dates or claims issues with commercial payers
Review and verify enrollment grids for accuracy
Monitor CAQH to ensure data elements are accurate
Coordinate the reconciliation process for assigned practices
Report trends of payer behavior
Stay informed on product information, changes in CMS/Commercial Payer procedures, and updates in policies
Manage short-term projects and tasks as assigned by supervisor such as payer data reconciliations
Contribute to other company and departmental needs as requested
Maintain a climate of teamwork and collaborating problem-solving

Requirements

High School diploma or equivalent required
Strong knowledge of medical insurance and healthcare billing
Establishes and demonstrates competency in accounts receivable systems and associated applications
Ability to communicate effectively with insurance carriers, patients, and co-workers
Ability to comply with procedural guidelines and instructions and to solicit assistance when situations arise that deviate from the norm
Excellent verbal and auditory skills are required for communicating with internal staff, customers, and representatives from external departments and agencies
Salary Range USD $25.60 - USD $28.20 /Hr. This range serves as a good faith estimate and actual pay will encompass a number of factors, including a candidate's qualifications, skills, competencies, and experience



  • Melville, New York, United States Catholic Health Service Full time

    Job SummaryCatholic Health Service is seeking a highly skilled Payer Enrollment Coordinator to join our team. As a key member of our healthcare team, you will be responsible for ensuring timely and accurate physician contracting with our payer partners.Key ResponsibilitiesCoordinate the transition of physician payer enrollment to the IPAInteract with...


  • Melville, New York, United States Catholic Health Service Full time

    Payer Enrollment Coordinator Job SummaryCatholic Health Service is seeking a highly skilled Payer Enrollment Coordinator to join our team. As a key member of our Physician Partners department, you will be responsible for ensuring timely and accurate physician contracting with our payer partners.Key Responsibilities:Coordinate the transition of physician...


  • Melville, New York, United States Catholic Health Service Full time

    About the RoleCatholic Health Service is seeking a skilled Payer Enrollment Coordinator to join our team. As a key member of our organization, you will play a critical role in ensuring timely and accurate physician contracting with our payer partners.Key ResponsibilitiesLiaison between Practice Administrators and/or Billing Managers and insurance...


  • Melville, New York, United States NESCO Inc Full time

    Medical Billing SpecialistWe are seeking a detail-oriented Medical Billing Specialist to join our team at Nesco Resource. In this role, you will analyze patient accounts, resolve claim issues, and collaborate closely with third-party payers to ensure timely payments.Key Responsibilities:Investigate patient accounts: Follow up on hospital claims, reviewing...


  • Melville, New York, United States Catholic Health Full time

    Job Title: Revenue Integrity SpecialistCatholic Health is seeking a highly skilled Revenue Integrity Specialist to join our team. As a key member of our revenue cycle team, you will play a critical role in ensuring the accuracy and integrity of our revenue streams.Responsibilities:Provide guidance and communication on correct charge capture and billing...


  • Melville, New York, United States Catholic Health Service Full time

    Job Title: Revenue Integrity SpecialistCatholic Health Service is seeking a highly skilled Revenue Integrity Specialist to join our team. As a key member of our revenue cycle management department, you will play a critical role in ensuring accurate charge capture operations and revenue reconciliation processes.Job Summary:The Revenue Integrity Specialist...


  • Melville, New York, United States Catholic Health Service Full time

    Job Title: Revenue Cycle Escalation Unit AnalystCatholic Health is a leading healthcare provider on Long Island, with a strong commitment to serving our communities. We are seeking a skilled Revenue Cycle Escalation Unit Analyst to join our team.This role requires a thorough understanding of managed care contracts, policies, and procedures. The successful...


  • Melville, New York, United States YAI Full time

    Job Title: Assistant Behavior Intervention SpecialistYAI is seeking a highly motivated and compassionate Assistant Behavior Intervention Specialist to join our dynamic team. As a key member of our support staff, you will work directly with individuals with intellectual and developmental disabilities, providing daily living skills training, individual and...


  • Melville, New York, United States YAI Full time

    Job Title: Assistant Behavior Intervention SpecialistYAI is seeking a highly motivated and compassionate Assistant Behavior Intervention Specialist to join our dynamic team. As a key member of our support staff, you will work directly with individuals with intellectual and developmental disabilities, providing daily living skills training, individual and...


  • Melville, New York, United States Catholic Health Full time

    Job Summary:Catholic Health is seeking a highly skilled Patient Referral Liaison to join our team. As a key member of our healthcare team, you will be responsible for reviewing referrals in our electronic medical record (EMR), verifying insurance authorizations, and scheduling appointments to ensure our patients receive the right care at the right time with...


  • Melville, New York, United States Catholic Health Service Full time

    Job Title: Revenue Cycle Escalation Unit, AnalystOverview:Catholic Health is a leading healthcare provider on Long Island, with a strong commitment to serving the community. Our health system has a large workforce, multiple hospitals, and a network of physician practices across the island. We prioritize compassionate care and evidence-based practice to...


  • Melville, New York, United States The First National Bank of Long Island Full time

    Job OverviewThe First National Bank of Long Island is seeking a highly motivated IT Security Specialist to join our IT and Information Security team. As a key member of our team, you will have the opportunity to gain hands-on experience in the development and implementation of IT and information security policies and procedures, ensuring the confidentiality,...


  • Melville, New York, United States H2M Architects and Engineers Full time

    Job Title: Benefits and Compensation SpecialistAt H2M Architects and Engineers, we are seeking a highly skilled Benefits and Compensation Specialist to join our Human Resources team. This role will be responsible for delivering exceptional benefits and compensation programs to our employees, ensuring a positive and supportive work environment.Key...


  • Melville, New York, United States YAI Full time

    Job Title: Full Time Assistant Behavioral Intervention SpecialistYAI is seeking a highly motivated and experienced Assistant Behavioral Intervention Specialist to join our dynamic team. As an Assistant Behavioral Intervention Specialist, you will work directly with individuals with intellectual and developmental disabilities, providing support and guidance...


  • Melville, New York, United States YAI Full time

    Job Title: Assistant Behavior Intervention SpecialistYAI is seeking a highly motivated and experienced Assistant Behavior Intervention Specialist to join our dynamic team. As a key member of our team, you will play a vital role in providing support to individuals with intellectual and developmental disabilities.Key Responsibilities:Provide direct care...


  • Melville, New York, United States H2M Architects and Engineers Full time

    Job Title: Benefits and Compensation SpecialistThis role is responsible for delivering exceptional benefits and compensation programs to support the company's growth and success.Key Responsibilities:Manage the benefits administration process, including health insurance, retirement plans, and other employee benefits.Coordinate regular meetings with benefit...


  • Melville, New York, United States eVero Corporation Full time

    Job SummaryeVero Corporation is seeking a highly motivated and tech-savvy Human Resource Specialist to join our team. As a key member of our HR department, you will provide administrative support to various critical human resources functions, including benefits administration, performance management tools, onboarding, employee record system, recruiting, and...

  • IRS Tax Consultant

    2 days ago


    Melville, New York, United States Crawford Thomas Recruiting Full time

    IRS Tax Consultant OpportunityWe are seeking a highly skilled and experienced IRS Tax Consultant to join our team in Melville, NY. The ideal candidate will have Active Enrolled Agent Certification in the state of NY.Responsibilities:Monitor and process change of address notifications and 8821 tax forms on a monthly basis.Ensure compliance with IRS...

  • IRS Tax Consultant

    4 days ago


    Melville, New York, United States Crawford Thomas Recruiting Full time

    IRS Tax Consultant OpportunityWe are seeking a highly skilled and experienced IRS Tax Consultant to join our team in Melville, NY. The ideal candidate will have Active Enrolled Agent Certification in the state of NY.Key Responsibilities:Monitor and process change of address notifications and 8821 tax forms on a monthly basis, utilizing in-depth knowledge of...


  • Melville, New York, United States Travelers Full time

    About the OpportunityWe are seeking a highly skilled Counsel to join our team at Travelers, where you will have the opportunity to utilize your legal expertise and litigation skills to handle a caseload of predominantly low to moderate complexity and deliver optimal results for our insured customers.Key ResponsibilitiesDevelop and apply effective use of...