Key Facts

Remote From:

Iowa (USA) , Minnesota (USA) , North Dakota (USA) , South Dakota (USA)

Full time

English

Hard Skills

Enrollment Management Account Management Billing Stakeholder Engagement Claims And Litigation Management Provider Data Management Credential Manager Customer Inquiries Compliance Management

Other Skills

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Microsoft Office
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Computer Literacy
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Communication
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Time Management
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Teamwork
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Detail Oriented
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Problem Solving

Roles & Responsibilities

High school diploma or equivalent preferred
Previous experience as Billing Representative, Credentialing, or Provider Enrollment preferred
General computer skills, including the ability to use Microsoft Office products

Requirements:

Ensure timely enrollment of new providers and new facility sites with payors, and maintain ongoing enrollment including re-enrollment and terminations
Monitor and maintain accurate provider directory and payor database information; follow up with payors for effective dates, status updates, and identification numbers; update data in internal and external billing systems
Prepare and maintain supporting enrollment documentation (W-9, CLIA, bank, IRS, CMS letters) and assist with NPI/NPPES applications; notify payors and internal contacts of practitioner and site changes
Resolve enrollment-related denials and related issues, including follow-up with payors, remaining in compliance with regulations; respond to internal and external inquiries; participate in Epic queues and site-planning meetings

Good Samaritan Society

About Good Samaritan Society

The Evangelical Lutheran Good Samaritan Society is the largest not-for-profit provider of senior care and services in the United States. More than 27,000 people of all beliefs and faiths call us home. Locations: Arizona, Arkansas, Colorado, Florida, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Minnesota, Montana, Nebraska, New Mexico, North Dakota, Ohio, Oregon, South Dakota, Tennessee, Texas, Washington, West Virginia and Wisconsin. The Society’s mission is based in love. In fact, love is the motivation behind the care we provide. In recent months, we’ve begun to challenge ourselves to go the extra mile in finding new ways to share Christ’s love with the people around us. We’re highlighting eight profound traits that Jesus showed us. In addition to love, the traits are compassion, acceptance, joy, humility, honesty, courage and perseverance. The Good Samaritan Society Way is the name we have given this emphasis. It’s a new way of talking about sharing God’s love. But it’s an extension of what we’ve always done and how we’ve always loved the people in our care. We’re accepting this challenge to bring these eight traits of Jesus into our daily work and relationships. Connect with us! Careers: www.good-sam.com/careers Notice of Nondiscrimination and Accessibility Requirements: https://www.good-sam.com/assets/uploads/general/16-G1099_RSV3931_PST_AH_ForWeb_OUTLINES3.pdf

Company type: XLarge

Founded: 2018

Company size: 10001

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Job description

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We’re proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.

Work Shift:

8 Hours - Day Shifts (United States of America)

Scheduled Weekly Hours:

Salary Range: $19.00 - $30.50

Union Position:

Department Details

Summary

Responsible for ensuring the timely enrollment of new providers with payors as well as new facility sites. Responsible for the on-going maintenance of existing providers and facility sites including re-enrollment and maintaining terminations.

Job Description

Monitor and maintain the process of gathering current, accurate, and complete information for provider directories and payor databases in compliance with regulations and payor requirements. Follow up with payors to obtain effective dates, status updates, and identification numbers for billing purposes. Update and maintain provider numbers and related data in both internal and external billing software and production programs. Maintain supporting documentation such as a W-9, CLIA certificate, bank, IRS, and CMS letters as applicable. Apply for or provide assistance with the application process for individual practitioner and/or facility national provider identifier (NPI) via national plan and provider enumeration system (NPPES). Notify payors and internal contacts of practitioner practice changes, including terminations, cases of malpractice, or other legal matters. Also will notify payors of site notification for payors (i.e., for new sites, site terminations, and changes). Perform account follow up on enrollment related denials and take the necessary action for account resolution in accordance with established federal and state regulations. Respond to internal and external inquiries regarding research issues. Review charges and claims pending report and/or claim edit work queues in Epic. May work Epic follow-up work queues to resolve enrollment-related issues. Keep current regarding any changes in managed care and other payor requirements for provider enrollment. Complete work within authorized time to assure compliance with strict departmental and compliance standards as well as payor time limits. Initiate enrollment for electronic claims submission. Attend site-planning meetings to provide input, gather necessary information for set up, and provide updates.

Qualifications

High school diploma or equivalent preferred.

Previous experience as Billing Representative, Credentialing, or Provider Enrollment preferred. General computer skills, including the ability to use the range of Microsoft products General computer skills, including the ability to use the range of Microsoft products required.

Sanford is an EEO/AA Employer M/F/Disability/Vet.

If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-673-0854 or send an email to talent@sanfordhealth.org.