Are you looking to make a difference by improving the health of our patients? Here you will find an innovative culture that is patient focused and dedicated to making a difference. We are committed to helping the population we serve, and our communities achieve optimum health and enjoy the best quality of life possible. Recently named a Forbes America's Best-In-State Employer 2022!

Under the direction of the Manager Physician Reimbursement, the Provider Enrollment Coordinator enrolls all eligible providers with payers for reimbursement to the Bassett Healthcare Network. Works with Information Technology department to update the SER records in EPIC. Enrollment Works in cooperation with the Office of Medical Staff Affairs, providers, and BMG and hospital personnel. Provides high-quality, timely enrollment services, initiating and maintaining consistent cash flow and compliance with third party enrollment/credentialing requirements. Serves as a resource for training, quality control, as well as team leader for the unit. Serves as a communication liaison to all Health Centers, Medical Staff Affairs and Billing Staff as appropriate.

• Financial: Provide accurate data of attending and referring providers.
• Ensures completed enrollment applications are submitted within 2days of receipt 90% of the time in order to expedite submission of claims as monitored by management utilizing provider tracking reports.
• Maintain an error rate of less than 10 occurrences that cause claim denial, when completing applications and communicating with Information Technology department which ensures clean claims submission. Success will be monitored by management and feedback from other staff.
• Work with billing units to assist in the prompt resolution of edits and rejections as they arise of claims impacted by the enrollment. Utilizing EPIC WQ's. Success will be monitored by management and feedback from other staff.
• Monitor submitted enrollment/credentialing applications with payers and providers biweekly, submitting information to information technology department for updating the SER. and initiate subsequent steps necessary for completion of the reimbursement process. Monitored by management and feedback from other staff.
• Monitors EPIC WQ's to ensure follow up is being done accurately and within the time limits of the carrier as monitored by the Patient Billing Managers.
• Information: Shares information timely while maintaining confidentiality.
• Consistently ensures that information known about the customer is kept private and confidential as observed by Management and feedback from other staff and/or providers.
• Communicate with all departments and payers, changes or issues with regard to provider status within 72 hours of notification as monitored by management.
• Updates unit database and Medical Staff Affairs with information provided by payers as received. Provide unit database information upon valid requests to payers, county agencies, providers of durable medical equipment, etc. Success is monitored by management and feedback from other staff.
• Complies with all privacy (HIPAA) regulations and adheres to Bassett’s confidentiality policies. Success is monitored by Management through feedback other staff.
• Initiate Information Service system modification update process as need arises to maintain synchronization of multiple provider databases for the organization’s interfaced software applications as observed by management and feedback from other staff.
• Prepare and distribute provider updates or new additions to departments as identified on Distribution list.
• Relationships: Maintains a strong working relationship with all Bassett customers.
• Communicate information upon receipt obtained to appropriate internal and external users as determined by departmental procedures. Success is monitored by management observation and feedback from others.
• Presents a positive image of Bassett Healthcare 100% of the time through professional appearance and behavior as observed by management.
• Works cooperatively within own unit/department and with other units/departments as observed by management and feedback from customers.
• Treats customers (guests, patients, physicians and other employees) with courtesy, respect and caring behavior as observed by Management and feedback from other staff members or providers.
• Operational/Procedural: Initiating processes for all enrollable healthcare providers.
• Keep current in respect to payer enrollment requirements 100% of the time as monitored by Management utilizing provider enrollment report and tracking of denials.
• Prepare multiple enrollment/credentialing applications for signature upon notification from Administration/Medical Staff Affairs. Success will be monitored by Management observation and feedback from managers and Medical Staff Affairs.
• Prepare re-certifications for provider signature as required by payers upon receipt as monitored by management utilizing provider enrollment reports and feedback from billing unit.
• Provide updates to payers regarding current provider coverage arrangements, terminations and total provider staff listings as changes occur. Success will be monitored by Management and feedback from other staff and third-party payors.
• Work EPIC provider on the fly and submit tickets to information technology based on requests from multiple sources within 24 hours of receipt as monitored by feedback from other staff.
• Orients newly hired physicians and allied health professionals to provide explanation of enrollment process and obtain authorized signatures in accordance with carrier requirements at provider orientation or as provider schedule allows. Success will be measured by Management observation and feedback from departmental staff.
• Performs similar or related duties as requested or directed.

Education:

• 2 year Associate Degree preferred

• Knowledgeable with MS Access, Excel, and word processing applications

Experience:

• Minimum 5 years experience in the area of physician enrollment, billing and/or reimbursement required

Skills:

• Organizing/Categorizing records
• Interacting with People
• Communication
• Accounting
• Computer Skills

Physical Requirements:

• Sedentary Work - Exerting up to 10 lbs of force occasionally, and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects. Sedentary work involves sitting most of the time. Jobs are sedentary if walking or standing are required only occasionally, and all other sedentary criteria are met.
• Occasional hearing, repetitive motion, standing, talking, walking
• Constant typing/clerical/dexterity, standing

Travel:

• Occasional Travel - The job may require travel from time- to-time, but not on a regular basis.

Bassett Healthcare Network’s commitment to our employees includes benefit programs carefully designed with the needs and values of all our employees in mind. Many of the benefits we offer are paid fully or in large part by Bassett. Our generous benefits offerings include:

• Paid time off, including company holidays, vacation, and sick time
• Medical, dental and vision insurance
• Life insurance and disability protection
• Retirement benefits including an employer match 
• And more!

Specific benefit offerings may vary by location and/or position.

Salary is based on a variety of factors, including, but not limited to, qualifications, experience, education, licenses, specialty, training, and fair market evaluation based on industry standards. The above compensation range represents a good faith belief of the compensation range by Bassett Healthcare Network, and its entities and affiliates, at the time of this posting or advertisement.

We provide equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, creed, sex (including pregnancy, childbirth, or related condition), age, national origin or ancestry, citizenship, disability, marital status, sexual orientation, gender identity or expression (including transgender status), genetic predisposition or carrier status, military or veteran status, familial status, status a victim of domestic violence, or any other status protected by law.