Provider Enrollment Specialist Senior Job at CHRISTUS Health (Irving)

Job Description

This role serves as a Payer Enrollment liaison. Represents Payer Enrollment on matrix calls. Collaborates with Credentialing team and local operations to ensure timely payer enrollment. Coordinates Medicare and Medicaid enrollment/re-enrollment as well as commercial payer credentialing and enrollment Maintains NPI files and provider numbers. Serves as customer service liaison. Interacts with providers, Operation leaders, insurance carriers, and practice personnel concerning payer enrollment. Performs all functions in a courteous and professional manner.

Job Responsibility

Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders
Collaborates with CBO and local operations on enrollment related issues
Attends and provides enrollment related updates on matrix calls
Collaborates with Credentialing Team and local operations on items needed
Updates Credentialing/Payer Enrollment database as needed
Accesses payer databases as needed to ensure appropriate enrollment
Performs multi-state Medicaid Enrollment through state portals
Submits updates as needed to payers
Maintains internal enrollment database
Educates associates on enrollment processes when needed
Performs required tasks of Delegated Payers as needed
Prepares and submits applications/or required documents to Payers for new provider enrollments and existing provider updates
Collects and maintains data on providers for Medicare and Medicaid enrollment
Communicates with provider to perform multi-factor-authentication process as needed
Complies with Medicare and Medicaid provider enrollment guidelines
Communicates information to appropriate personnel
Participates in company sponsored enrollment/credentialing meetings and other educational activities
Follows the Health Insurance Portabillity and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of PHI
Maintains strict confidentiality
Uses oral and written communication skills to effectively convey ideas in a clear, positive manner that is consistent with the CHRISTUS Mission
Maintains established CHRISTUS policies, procedures, objectives, quality assurance, safety, environmental and infection control
Implements job responsibilities in a manner that is consistent with the CHRISTUS mission, code of ethics and is supportive of the cultural diversity objectives
Performs other work as required.

Requirements

High school diploma or equivalent required
3-5 years of Payer Enrollment experience preferred
Solid knowledge and utilization of PC applications including Microsoft Word and Excel
Excellent written and verbal communication skills
Excellent organization and planning skills with demonstrated teamwork skills
Proven ability to interact with all levels of management and other Associates
In accordance with the CHRISTUS Health License, Certification and Registration Verification Policy, all Associates are required to obtain the required certifications for their respective positions within the designated time frame.

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Provider Enrollment Specialist Senior

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