Offer summary

Qualifications:

Bachelor's degree or associate's degree with 3+ years of payer enrollment experience., At least 2 years of experience in managed care, credentialing, or healthcare environment., Proficiency in Microsoft Office and credentialing software preferred., Strong organizational, attention to detail, and interpersonal skills..

Key responsibilities:

Manage and update payer information for hospital TINs and medical groups.

Coordinate and execute a comprehensive Tax ID change project across payers.

Ensure timely application submissions and maintain documentation for enrollment activities.

Collaborate with internal teams and payers to update records and prevent revenue disruptions.

Job description

The Payer Enrollment Transition Coordinator is responsible for the accurate and timely enrolment and maintenance of all hospital TINs and medical group name changes with commercial and government payers. This includes managing credential databases, application submissions, and communication with payers to ensure no interruptions in revenue. A critical focus of this role will include overseeing and executing a comprehensive Tax ID change project for a large hospital system and medical group, encompassing all payers and including updates to EDI (Electronic Data Interchange), ERA (Electronic Remittance Advice), and EFT (Electronic Funds Transfer) information. Spec: 1. Coordinate and maintain accurate payer information for all hospital TINs and medical group name changes within the credentialing database. 2. Manage data updates and records related to all hospital TINs and medical group name changes. 3. Complete and submit applications for all hospital TINs and medical group name changes to contracted payers, meeting all regulatory and compliance requirements. 4. Track application statuses to ensure successful completion and enrolment under all hospital TINs and medical group name changes. 5. Maintain documentation of effective dates and payer-assigned identification numbers related to all hospital TINs and medical group name changes. 6. Execute re-credentialing and re-validation processes for all hospital TINs and medical group name changes in accordance with payer timelines. 7. Submit timely updates to payers for any additions, changes, or terminations related to all hospital TINs and medical group name changes. 8. Verify demographic and practice information related to all hospital TINs and medical group name changes as required by contracted payers. 9. Serve as the point of contact for a Tax ID transition project, leading coordination with all payers to update records, including EDI, ERA, and EFT for all hospital TINs and medical group name changes. 10. Maintain organized digital files and records of all enrollment activities associated with all hospital TINs and medical group name changes. 11. Communicate proactively with the VP, Revenue Cycle regarding delays or issues in payer enrollment for all hospital TINs and medical group name changes. 12. Distribute and review required enrollment documents, ensuring completeness and adherence to payer-specific requirements for all hospital TINs and medical group name changes. 13. Coordinate changes in the Epic system for Revenue Cycle in collaboration with IT&S 14. Work with Payer Contracting team and collaborate with the Revenue Cycle team. 15. Manage changes to hospital licenses, DEA registration, and liability insurance documentation. 16. Collaborate with Revenue Management to ensure timely reimbursements and avoid disruptions related to all hospital TINs and medical group name changes. 17. Provide support for internal and external audits related to payer enrollment for all hospital TINs and medical group name changes. Required Qualifications: 1. Formal Education Required Bachelor's degree, or associate's degree with at least three (3) years of experience in payer enrollment. 2. Experience & Training Required Minimum of two (2) years in managed care, medical staff/credentialing, or a similar healthcare-related environment. 3. Other Skills, Competencies and Qualifications a) Excellent organizational, time management, and multi-tasking skills. b) Strong interpersonal skills to build effective working relationships internally and externally. c) Proficient in Microsoft Outlook, Word, Excel; Adobe Acrobat Professional and credentialing software preferred. d) High attention to detail with analytical and research skills. e) Proven dedication to follow-through and achieve results f) Flexible g) Understand credentialing and payer enrollment process
Unit Description
Remote This is a temporary, project-based role of a minimum of 25 hours weekly and a maximum of 35 hours weekly set for at least one (1) year with a start date contingent upon the organization's transition to acquisition close. Bachelor's degree, or Associate's degree with at least three (3) years of experience in payer enrollment. 2. Experience & Training Required - Minimum of two (2) years in managed care, medical staff/credentialing, or a similar healthcare-related environment

Required profile