Payor Enrollment Specialist

Base Pay Range:

$21.46 - $32.20

Job Description:

The Payor Enrollment Specialist is a Full Time, Regular position working Monday-Friday 7am-4pm, but hours can be flexible. This is hybrid position after training working in at home 3 days per week and 2 days in office Downtown Spokane.

Summary:  Completes payor enrollment for facilities and practitioners.

General Description:  The Payor Enrollment Specialist is responsible for updating and creating new payer enrollments for all Inland Imaging organizations.

Essential Duties/Responsibilities: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Gathers forms and data requirements from individual payers and compiles documents
• Completes all paper and on-line forms and disseminates forms to the physicians with the appropriate instructions.
• Reviews all returned forms for accuracy and completeness.
• Maintains enrollment matrix.
• Prepares and disseminates correspondence.
• Sends applications and enrollments to the individual payers; follows through with payers and team in a timely manner to procure proper enrollments.
• Interprets enrollment regulations accurately and in keeping with federal, state and third-party billing regulations and policies.    
• Prioritizes outstanding enrollments appropriately.
• Coordinates new physician enrollments with the credentialing coordinator.
• Enrolls new locations with payers in a timely manner.
• Works with RBS team on credentialing denial investigations and timely follow-up.

• Timeliness and accuracy are paramount in this role.

General Duties and Responsibilities:

• Ability to maintain strict confidentiality within the Inland Imaging companies
• Follows all Health and Safety policies and guidelines of Inland Imaging
• Follows all company policies including those regarding harassment, non-retaliation, discrimination, respectful workplace, and related policies.
• Follows all policies regarding HIPAA, non-disclosure of confidential information and company security.
• Honest, pleasant manner and good personal hygiene.
• Free of alcohol and drug abuse.
• Valid state driver’s license and proof of insurance.
• Excellent communication and interpersonal skills.
• Detail oriented; ability to multi-task; organized and able to work in a fast-paced environment.
• Demonstrates self-directed learning and participation in continuing education through professional journals, approved seminars, etc.
• Ability to consider individual needs in communication with and assessment and treatment of patients of all ages.

• Adheres to departmental standards and personnel policies by demonstrating professional demeanor in conduct and appearance.
• Follows company departmental standards and personnel policies by using good teamwork and communication skills to help identify concerns and solutions, assisting where needed to ensure a smooth functioning department.
• Performs other duties as required by displaying team spirit and self-growth, accepting, and performing other projects and responsibilities, and requesting other projects and responsibilities.
• Attendance is a requirement for this position.
• Rotates to other shifts and locations as needed.
• Performs other special projects and duties as assigned.

Supervisory Responsibilities:

• There is little or no supervisory responsibility in this position

Advocacy:

Treats all clients with dignity and respect Provides excellent customer service Conforms to Joint Commission and HIPAA regulations Complies with PHI (Protected Health Information) Demonstrates the Inland Imaging Core Values:

• Show We Care, Do The Right Thing, Maximize Individual Potential, Always Aim Higher

Qualifications:  

• Education: High School Diploma/GED required
  • Two-year medical billing course is desired
• Experience: At least 2 years of experience in billing requirements for either government or commercial insurers, or experience in provider enrollment.
• Familiarity and experience with Washington’s One Health Port, Echo One, DocuSign, Individual Payer websites. CAQH and Medicare PECOS provider enrollment systems is a plus.
• Licensure:   N/A
• Certifications:  Credentialing certification is desired.
• Computer Skills:  Experience with the following computer applications is highly desired: Microsoft Office products (Outlook, Word, Excel); Workday, Internet, Intranet, Qgenda.
• Background Check:
  • Must be able to pass a background check required by RCW 43.43.830-840 to work with children under the age of 16, developmentally disabled persons or vulnerable adults
  • In order to comply with provisions set forth in Sections 1128 and 1156 of the Social Security Act, all new employees of Inland Imaging Business Associates will be checked against the LIST OF EXCLUDED INDIVIDUALS provided by the Department of Health & Human Services, Office of the Inspector General (OIG).  Employees must not be included on this list.  
• Drug Test: Eligible employees must be able to pass a post-offer, pre-employment drug test.
• Ability to work from a remote location (home) under hybrid model.
• Required to have a dedicated area to perform the job, that is private and has a desk, chair, appropriate lighting, and access to internet.

Nuvodia/Inland is an EEO employer...