Payer Enrollment Specialist

Location: Columbus Regional Hospital

Dept: 9103 CRH Patient Financial Services

Category: Professional

Full Time, Days, 40 hours

Posted 5/9/2022

Requisition # 9292

What you need to know about the Payer Enrollment Specialist Position:

  • Payer Enrollment Specialist processes credentialing and re-credentialing applications of health care providers, reviews applications, letters, and maintains credentialing database. The Payer Enrollment Specialist contacts medical office staff, licensing agencies, and completes insurance credentialing and re-credentialing applications. Payer Enrollment Specialist has knowledge of payer credentialing and licensure requirements. This position does not provide direct patient care.
  • As a Payer Enrollment Specialist, you will be responsible for processing provider payer applications, initial, re-applications and attestations, entering provider demographic and credentialing data into credentialing databases including but not limited to Council for Affordable Quality Healthcare (CAQH), State license agency, and Symplr, completing and disseminating to health plans requested provider data, understanding Medicare, Medicaid and commercial payer application process and Electronic Data Interchange (EDI) agreements for providers and facilities, completing credentialing of new physicians with payers and managed care plans, completing re-credentialing established providers with Medicare, Medicaid and commercial payers through CAQH.
  • Additionally, this position will maintain Credentialing files (paper and electronic), coordinate and participate in all phases of credentialing/re-credentialing profile process and complete all documentation and data entry into database system.
  • The Payer Enrollment Specialist position has a base hourly rate of $20.40, pay will commensurate with experience.
  • This position will require you to work Monday through Friday, 8:00 AM to 4:30 PM, 40 hours per week. Remote work position.

What is required for this position:

  • Associates Degree and/or 2 – 4 year’s work experience in an applicable field required.
  • Experience with the completion and submission of payer credentialing applications required.
  • Experience with medical terminology required.

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