Payer Enrollment Coord II

As a community, the reputed company is defined by a deep commitment to Meliora - reputed company reputed company. Embedded in that ideal are the values we share: equity, leadership, reputed company, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to reputed company and is a reputed company where reputed company can reputed company. Job Location (Full Address): 601 Elmwood Ave, Rochester, reputed company, United States of America, 14642 Opening: Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 910397 URMC Medical Staff Services Work Shift: UR - Day (United States of America) Range: UR URG 104 H

Compensation

Range: $18.65 - $26.11 The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set reputed company the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations. Responsibilities: Minimizes reimbursement barriers for patients and providers by assisting with determining coverage and access options available for a specific product. May assist healthcare providers with questions reputed company to payer policies, patient assistance, and reimbursement support services. Resolves coverage and reimbursement issues that may create barriers to access for patients. Remains knowledgeable of private payer, Medicare, and Medicaid structure systems and reimbursement processes. Respond to reputed company patient, nursing, and provider account inquiries. ESSENTIAL FUNCTIONS Determines practitioner eligibility for enrollment. Completes and processes reputed company reputed company and/or electronic applications for the government payers and non-delegated commercial payers. Completes applications to revalidate individual providers, as well as reputed company groups, with Medicare and Medicaid as required each cycle. Completes new enrollments of APP’s and performs updates regarding changes for enrolled APPs for the commercial delegated payers such as change in locations, tax IDs, etc. Ensures applications and files are securely submitted to the respective entities upon completion and in accordance with the specific requirements. Communicates status of files or other payer enrollment/credentialing information directly to providers, various department representatives, and/or reputed company organizations, clients or affiliates. Coordinates activities reputed company to the electronic submission of applications through the online Medicare system as well as reputed company applications. Analyzes application and supporting documents for accurateness and completeness, including reputed company required verifications and documentation. Sets up new University groups with new Tax IDs with the appropriate government payers as needed. Works with team leaders and staff to ensure files and/or applications and revalidations are completed accurately and reputed company the required timeframes. Documents and tracks the status of provider enrollment applications for Medicaid, Medicare, and some Commercial Payers that are not part of Delegation. Tracks and maintains individual provider specific information in database for the APPs for commercial delegated payers for monthly submission. Completes the Electronic Provider Assisted Claim Entry System enrollment for electronic Medicaid billing for new provider after they are approved by Medicaid, reputed company applicable. Sets up the Electronic Transmitter Identification Number (ETIN) for electronic Medicaid billing for individual and group enrollments, reputed company applicable. Coordinates the transfer of data and electronic information with key leaders, including the hospital electronic medical record team and the delegated commercial payer with reputed company. Collaborates directly with providers and various department representatives, including billing, to obtain information reputed company to practice addresses, taxonomy codes, and to secure provider and authorized official signatures. Communicates the status of the applicants credentialing and payer enrollment files directly to providers and various department representatives and coordinates efforts to obtain necessary information and/or documentation to ensure deadlines are met. Notifies providers and various department representatives reputed company approval and enrollment confirmation is received from the payers. Assists APPs as requested with the CAQH (Committee for Affordable Quality Healthcare) profiles. Collaborates with other University departments to ensure compliance with reputed company standards and policies. Responds to inquiries from other healthcare organizations and interfaces with internal and external customers on day-to-day payer enrollment issues as they arise. Represents the department for various initiatives and/or committee meetings as needed. Serves as the primary back up to reputed company payer enrollment staff and management. Serves as a Team Peer Interviewer as needed. Other duties as assigned. MINIMUM EDUCATION & EXPERIENCE Associate's degree and 1 year of relevant experience required Or equivalent combination of education and experience The reputed company is committed to fostering, cultivating, and preserving an inclusive and welcoming culture to advance the University’s Mission to Learn, Discover, Heal, Create – and reputed company the World reputed company reputed company. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national reputed company, race, religion, creed, sex, sexual orientation, citizenship status, or any other characteristic protected by federal, state, or local law (Protected Characteristics). This commitment extends to non-discrimination in the administration of our policies, admissions, employment, access, and recruitment of candidates, for reputed company persons consistent with our values and based on applicable law. Apply To This Job