Provider Enrollment & HR Analyst

FLSA Status: Non-Exempt

Starting Range: $24.50- $28.57 per hour

Located at 899 Main St., Buffalo, NY 35 Hours Full-Time

Summary Of Duties

The Provider Enrollment & HR Analyst is responsible for preparing and submitting applications and supporting documentation for the purpose of enrolling individual physicians and physician groups with payers. The Provider Enrollment & HR Analyst also processes new applications, revalidations, and updates roster, performs confidential administrative tasks associated with the human resource management of the agency. The Provider Enrollment & HR Analyst will maintain HR files in accordance with all mandating guidelines. Builds and runs reports on an as needed basis. Works with multidisciplinary team to develop, track, and monitor quality & compliance indicators, staff in-services, mandatory and elective trainings, and quality improvement information.

Position Responsibilities

Provider Enrollment

• Maintain updated knowledge of Provider Enrollment regulations and develop new/update existing procedure documentation.
• Collaborate with insurance carriers to ensure the team is enrolling new BestSelf programs by following the applicable requirements and enrollment procedures.
• Investigate new external electronic platforms used by insurance carriers and ensure the team is prepared to utilize efficiently and effectively.
• Receive and analyze all verified documentation for Providers and execute provider enrollment with carriers.
• Process new enrollments, revalidations, and making sure all providers are linked with their appropriate sites.
• Shares essential updates with providers and internal teams as necessary in weekly summary reports or other correspondence.
• Collaborate with the Billing team on enrollment issues to investigate and correct.
• Work closely and effectively with the Insurance Carriers and Providers.
• Correspond with providers and Program Directors as necessary.
• Establish a relationship with the carrier credentialing representative and keep up on any changes or updates with the carriers.
• Communicate with providers on any enrollment issues, needs and updates.
• Update Providers CAQH accounts.
  
  

HRIS

• Runs various audit reports on a determined frequency from the HRMS to ensure employee data and file documentation is compliant.
• Provide reports to HR management team, SMT and/or EMT as requested by the Talent Acquisition and HRIS Manager.
• Protects employee data by maintaining access rights to our employee databases and documents.
• Assists the Talent Acquisition & HRIS Manager in confidential tasks associated with Human Resource management of the agency.
• Enters, updates, and verifies data in HRMS as directed.
• Works closely with the other branches within the agency to provide a seamless employee experience as it relates to their career, wages, and benefits.
• Serve as a liaison between the agency and our HR systems in developing new processes and resolving any technology issues that may arise.
• Using state and national web sites, monitors license and other sanctions monthly.
• Develops and maintains mechanisms to track agency wide audit information, such as excel spread sheets and HR software.
• Promote agency's Racial Equity and Inclusion concepts.
• Builds and maintains an effective, professional, and positive working relationship with all levels of employees
• Provides timely, caring, and thorough employee service when employee inquiries are received.
• Provide support and guidance to the HRIS and Talent Acquisition teams as needed and as requested.
• Maintain confidentially and containment with to remain in compliance with HIPAA and protect employee information at all times.
• Completes all trainings required by the agency.
• Performs all other duties as assigned.
  
  

Qualifications

• Bachelor's degree in Business or Human Resources and 2 years of HR related experience - OR- Associate's degree in Business or Human Resources and 4 years of HR related experience
• PLUS 2 years of experience with processing the full Provider Enrollment cycle.
• Strong knowledge working with report writing databases as well as common office technology/software including the use of the Microsoft Office Suite.
• Ability to maintain confidentiality
• Excellent communication skills with all levels of staff
• Efficient time management
• High attention to detail
• Understanding of the agency's programs and services
• Experience working with and full understanding of insurance carriers' processes.
• Familiarity with NCQA standards and how to apply them.
• Proficient with basic computer systems, networks, and software applications, such as the Microsoft Office Suite (Outlook, Word, and Excel).
  

Benefits Include

• Generous paid time
• Multiple health insurance options
• Employee referral bonus
• Tuition Reimbursement
• Clinical license renewal reimbursement