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Payor Enrollment Coordinator

2 months ago

Phoenix, Arizona, United States HonorHealth Full time
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.

Key Responsibilities:
  • Payor Enrollment and Credentialing Support: Provides payor enrollment and credentialing support to the credentialing manager, maintaining a sound working knowledge of payor enrollment, payor credentialing, and providing consultation regarding payor enrollment and credentialing to ensure all processes are in compliance with state statutes and regulatory agencies.
  • Application Processing: Responsible for timely processing of health plan initial applications and reappointment applications for completeness and in accordance with appropriate standards, communicating with health plans during the enrollment process to ensure timely and expeditious completion of the process.
  • Database Management: Maintains the payor enrollment and credentialing database for physician and faculty, ensuring data is accurately entered and prepares reports in compliance with requests for information.
  • Confidentiality and Data Security: 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, assuring data security and confidentiality by use of appropriate labeling of information and storage.
Requirements:
  • Education: High School Diploma or GED Required
  • Experience: 2 years credentialing, payor enrollment, medical staff or administrative assistant experience, including data entry, in a hospital or healthcare environment