Job Description

Job Description

HHHN Mission

To provide the best health care, and access to that care, for everyone in our communities.

HHHN Vision

To pioneer an innovative, sustainable and community-focused health system through comprehensive primary care and diverse partnerships

Proposed Schedule : 30 hours per week. Monday - Friday, 8am - 2pm.

Note : This position is fully remote but must live within driving distance to Queensbury, NY.

Position Summary

The Payer Enrollment Coordinator is responsible for all insurance payer enrollment and re-enrollment for HHHN network providers and facilities.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily :

Essential Duties and Responsibilities :

• Organizes and implements the payer enrollment program to meet all regulatory rules, regulations as well as HHHN / s policies and procedures.
• Responsible for maintaining files in all areas such as : insurance provider and facilities files, Billing System(s), various spreadsheets, CAQH, NPPES and additional credentialing systems.
• Assists the Director of Revenue Cycle on special projects or with any additional tasks as assigned.
• All aspects of insurance payer enrollment for HHHN Medical and Dental Staff
• Database maintenance (Athena, Softdent, CAQH, NPPES, EMEDNY, etc.)
• Files maintenance (Provider and Facilities Insurance Files)
• Enrollment and re-enrollment applications with participating insurance plans
• Continuous contact with insurance payers to add, remove or update information.
• Maintenance of Network shared files (provider number spreadsheet)
• Processing Medicare, Medicaid and carious payer facility credentialing applications (i.e. CMS 855, Rate Based Applications, etc.)
• Responsible for creating maintaining and revolving all provider and facility holds as they relate to payer enrollment in the Billing Systems
• Communicates well both verbally and in writing with Providers and all external and internal customers.
• Assists in troubleshooting issues and providing support to the Director as needed
• Adhere to the guidelines as set forth in the Networks Remote Work Program and Expectations policy on the HWEB
• Perform additional duties and special projects as assigned

Qualifications : The requirements listed below are representative of the knowledge, skill and ability to perform the essential functions :

• Associates degree and 3 years related experience or High School diploma and 7 years related experience
• Excellent organizational and computer skills with experience in Microsoft Office products required
• Credentialing experience preferred

The pay range for this position is $19.00 - $20.00 per hour and will be based on knowledge and experience.

Last updated : 2024-07-09