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Payer Enrollment Specialist
2 months ago
Job Summary:
The Managed Care/Payer Enrollment Specialist will play a critical role in supporting the operational activities of Payer Enrollment at Mon Health. This position will be responsible for managing accounting and information systems in support of Managed Care/Payer Enrollment, as well as developing strategies to improve reimbursement levels under managed care agreements.
Key Responsibilities:
- Manage daily activities related to providing operational support for Payer Enrollment
- Develop and implement strategies to improve levels of reimbursement under managed care agreements
- Develop and guide organizational structure and processes necessary to support managed care agreements
- Work directly with Managed Care Organizations to resolve enrollment and administrative escalations occurring with Managed Care contracts
Requirements:
- High school diploma or equivalent required; Bachelor's degree preferred
- One to three years of current provider credentialing experience required
- Previous Hospital Credentialing experience required
- Basic to working knowledge of Centers for Medicaid and Medicare and Managed Care concepts, including Managed Medicare/Medicaid requirements, Disclosure of Ownership and Control Interest, and applicable laws/statutes/regulations
- Previous experience working with hospital contracts or demonstrated knowledge of contract principles and interpretation of contract language
- Certified Provider Credentialing Specialist (CPCS) certificate preferred or willingness to sit for CPCS within one (1) year of hire
Working at Mon Health:
As a member of the Mon Health team, you will have the opportunity to work in a patient-centered culture that values operational excellence and strategic growth. We are committed to providing our patients with the highest level of care and service, and we are seeking a highly skilled and motivated individual to join our team.
