Role /Title : Provider Enrollment Analyst Job Description:Shift – 4.30Pm to 1.30AM Budget - Upto 15LPA Experience – 5+ Years L3 & L4 experience , client facing roles. Ideal candidate would be a team player with advanced Excel & CAQH experience, who is organized, detail-oriented, flexible, transparent, and self-driven. Rosters / Payers:Generate, audit, and submit over 100 rosters per month for insurance company and other payers throughout the country as neededSubmit all rosters to supervisor or manager for audit, while working toward an error rate of less than 10% and no longer requiring auditsMonitor submitted provider enrollment rosters to ensure they are processed and approved by payers, and communicate required approvals to our billing team prior to timely filingComplete any provider demographic, payer validations, or audits requested within payers’ allotted timeframes or contracted termsSalesforce :Develop understanding of how to tag, filter, build relationships, and remove items in DocGen Packages, within Salesforce, to assist the rest of the team by auto-populating required documentsBegin to learn how to build dashboards to assist the rest of the team with managing their workloadOther:Manages daily administrative dutiesCommunicating data errors within our systems and notifying the applicable stakeholdersPrioritize requests and manage time and workload to execute project plans within given deadlinesMonitor fax, email inboxes, and SharePoint mail for the Provider Enrollment Analyst sub-teamComfortable with working remotely full-time with the ability to adapt and work independently with little guidanceClient Relationships:Responds timely to internal and external inquiries on any provider or contract matter including, but not limited to, routine follow up with payers on pending rosters and individual or practice location demographic inquiriesServe as liaison between our billing company, providers, and payer representatives for a multitude of purposesMaintain a strict level of confidentiality for all matters pertaining to provider credentials and informationFocus on tracking data integrity for the Provider Enrollment team and bring any concerns to their respective supervisor and managerCo-Design with colleagues and payer contacts so that ad-hoc demands are completed efficiently and painlesslyCompliance:Terminate inactive providers from insurance company, and other payer programs throughout the country to remain compliant with federal and state regulationsMaintain SB-137 and No Surprises Act rosters to remain compliant with federal and state regulationsEnsure data integrity across internal departments and payer systems through recurring validationsParticipate in trainings and development to mitigate compliance risk with state and federal regulationsBegin to research determine resolutions to various payer issues with an overall goal to lose no more than $100K in revenue per yearSupports research, review, and testing of educational materials for organization growthSystem Administration:Ensure Salesforce reporting functions and settings are correctly operating team wideUpdate records in Salesforce with all pertinent information required for data integrity and historical trackingDemonstrate extensive documentation in all databases (i.e., Salesforce, Wrike, SharePoint, Teams, etc.) for ongoing or open tasksAbility to use Salesforce Dataloader for bulk data importsProvider Enrollment Analyst Job Qualifications, Skills, Abilities, etcCompetencies (Knowledge/Skills/Abilities) desired:Advanced Excel knowledge, including but not limited to:VLOOKUPCONCATENATE / TEXTJOINand many other formatting formulasSalesforce (user side, not back-end side)Data managementReportingLogicWrikeMicrosoft TeamsMicrosoft OutlookCharacteristics desired: LogicalOrganized and Detail-OrientedIndependent Critical ThinkerDriven and ProactiveTeam PlayerPatient and FlexibleExpectations for Communication:Primarily through Wrike and TeamsWrike will hold all the employees’ tasks. All updates and questions should be there, if they are regarding the task itself.Any regular communication or things to be answered timelier, should be within Teams
Job Title
Provider Enrollment specialist