Healthcare Enrollment Specialist
2 months ago
Catholic 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 Responsibilities- 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
Catholic Health Service offers a competitive salary range of $28.20/Hr. In addition to the estimated base pay, we provide generous benefits packages, generous tuition assistance, a defined benefit pension plan, and a culture that supports professional and educational growth.
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