Payer Enrollment Specialist

3 days ago


Austin, Texas, United States The University of Texas at Austin Full time
Payer Enrollment Specialist

The University of Texas at Austin is seeking a highly skilled Payer Enrollment Specialist to join our team. As a key member of our revenue cycle team, you will be responsible for managing the enrollment process for healthcare providers within our clinics.

Key Responsibilities:

  • Assemble and submit credentialing application packets, maintaining practitioner files and ensuring confidentiality of all documents.
  • Enroll and maintain providers in Medicare, Medicaid, Commercial, and Managed Care payers, including managing NPI applications.
  • Collaborate with the Medical Staff Office to ensure current credentialing documents (e.g., CVs, licenses) are maintained.
  • Follow up on pending applications, enter data into CAQH profiles, and ensure quarterly re-attestation.
  • Build relationships with provider representatives and communicate application statuses to clinic and Revenue Cycle staff.
  • Provide reports to payers as per credentialing agreements and address credentialing-related inquiries across departments.
  • Coordinate with Revenue Cycle staff on claims denials and participate in payer audits as needed.

Requirements:

  • High school diploma, GED, or equivalent and 7 years of experience or Bachelor's degree and 3 years of experience in payer enrollment, credentialing, or a related field.
  • Strong ability to understand and follow directions, while developing and tracking implementation plans.
  • Effective verbal and written communication skills with payers, providers, and clinical operations teams.
  • Ability to establish and maintain effective working relationships with individuals.
  • Commitment to maintaining the confidentiality of provider information.
  • Proficient in using computers, with a working knowledge of Microsoft Office, especially Excel.
  • Capable of functioning in a fast-paced environment and adapting to changing assignments while multitasking.
  • Demonstrated problem-solving skills related to billing and credentialing issues.

Preferred Qualifications:

  • Previous experience working with a credentialing software.

Working Conditions:

  • May work around standard office conditions.
  • Repetitive use of a keyboard at a workstation.
  • Use of manual dexterity.

Required Materials:

  • Resume/CV.
  • 3 work references with their contact information; at least one reference should be from a supervisor.
  • Letter of interest.


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