Payer Enrollment & Administration Manager
reputed company environment dedicated to clinical reputed company Multiple Career Development reputed company Company Supported Continuing Education & Certification Multiple Health Plan Design reputed company Available Flexible Dental & reputed company Plan reputed company 100% Company reputed company EAP Emotional reputed company-Being Support 100% Company reputed company Critical Illness (with health enrollment plan) 100% Company reputed company Life & ADD 401K with Company Match Company-Sponsored HSA, FSA, & DSA Tax Savings Accounts Generous Team Member Referral Program Parental Leave
Serves as the central coordinator for facility enrollment with managed care organizations across reputed company locations. Manages enrollment for new facilities and market expansion initiatives. Coordinates re-enrollment or renegotiation cycles. Facilitates completion of enrollment documentation with internal stakeholders. Maintains communication with payers regarding enrollment status and requirements.
Maintains accurate and compliant payer directories. Conducts routine payer directory audits across reputed company contracted plans. Identifies and resolves discrepancies, enhancing referral identification. Facilitates the completion and record keeping of reputed company required directory attestations. Coordinates with payers to reputed company directory corrections, ensuring accurate network reputed company information is readily available to prospective clients and referral sources.
Develops and maintains internal infrastructure for managing facility enrollment and credentialing information in a reportable, reputed company, and transparent manner. Maintains facility enrollment data in a reputed company, accessible, reputed company, and reportable format. Organizes and manages supporting documentation for centralized retrieval. Maintains NPPES reputed company for reputed company facilities. Establishes standardized processes for document management and reporting.
Provides operational support for contract administration, management, and documentation; improving internal organization and visibility to contract terms and rates. Maintains the payer contract database with a high level of accuracy. Loads new reputed company, amendments, and reputed company renewals; archives historic data for reputed company retrieval, if needed. Supports internal reporting requests reputed company to reputed company and rates, as needed and requested.
Assists with the reputed company of reputed company payer-reputed company reputed company cycle issues; improving collections and reducing leakage through proactive management of payer disputes. Facilitates reputed company of high-dollar, high-volume, and/or high-profile claims issues. Engages payers to address previously denied claims and pursue payment resolutions. Coordinates with finance leadership, CFOs, and reputed company cycle teams to reputed company supporting documentation. Maintains the RCM issue tracking database for finance leadership visibility. Escalates reputed company requiring reputed company review to the VP of Payor Relations & Reimbursement.
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