FPA Provider Enrollment Analyst I

Description

Job Description

The Provider Enrollment Analyst (I) is responsible for coordinating the provider enrollment and payer credentialing efforts for contracted FPA providers with Medicare and Medicaid. This individual manages all open provider enrollment tasks/ issues to ensure that providers are reimbursed for services provided and billed, and performs data analysis and special projects as assigned.

Responsibilities

• Enrolls and terminates providers with CMS and other government programs by completing 855 series forms, gathers credentials and associated documentation required for enrollment and process enrollment forms.
• Tracks status of "in process" enrollment forms until final approval received.
• Files provider ID numbers once assigned by governing agencies and performs system updates as appropriate.
• Responsible for the initial setup of new groups and providers for 837P and 835P EDI transactions as well as EFT.
• Monitors TES edits, BAR edits, eCommerce edits, and payer denials for issues related to enrollment, and follow-up on claims until resolved.
• Participates in CBO rebilling efforts due to provider enrollment issues.
• Communicates with providers and other departments to escalate issues, share information and promote the process of obtaining documentation required for enrollment.
• Assists department administrators and providers in performing online PECOS enrollment.
• Assists in the Revalidation letter process, downloading list from CMS, obtaining comparison reports from the Medicare Provider Enrollment Database and scheduling providers for online re-enrollment.
• Utilizes the reports within the Medicare Provider Database to monitor updates, promptly complete work orders and identify work to be completed.
• May assist in special projects, generates metrics, and provides reconciliations, research, and analyses as directed by Management.
• Assists management with Meaningful Use and PQRI tracking and reporting.
• Supports activities related to internal and external audits of providers and/or departments.
• Responds to inquiries and provide information as requested.
• Performs other related duties as assigned.
  
  

Qualifications

• Two years minimum of healthcare experience including Medicare or Medicaid Provider or Facility Enrollment or Credentialing experience required, including one year of revenue cycle-specific as well as direct customer service.
  
  

Employer Description

Strength Through Diversity

Education

The Mount Sinai Health System believes that diversity, equity, and inclusion are key drivers for excellence. We share a common devotion to delivering exceptional patient care. When you join us, you become a part of Mount Sinai’s unrivaled record of achievement, education, and advancement as we revolutionize medicine together. We invite you to participate actively as a part of the Mount Sinai Health System team by:

• Using a lens of equity in all aspects of patient care delivery, education, and research to promote policies and practices to allow opportunities for all to thrive and reach their potential.
• Serving as a role model confronting racist, sexist, or other inappropriate actions by speaking up, challenging exclusionary organizational practices, and standing side-by-side in support of colleagues who experience discrimination.
• Inspiring and fostering an environment of anti-racist behaviors among and between departments and co-workers.
  
  

At Mount Sinai, our leaders strive to learn, empower others, and embrace change to further advance equity and improve the well-being of staff, patients, and the organization. We expect our leaders to embrace anti-racism, create a collaborative and respectful environment, and constructively disrupt the status quo to improve the system and enhance care for our patients. We work hard to create an inclusive, welcoming and nurturing work environment where all feel they are valued, belong and are able to advance professionally.

Explore more about this opportunity and how you can help us write a new chapter in our history!

“About The Mount Sinai Health System

Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 43,000 employees working across eight hospitals, more than 400 outpatient practices, more than 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time — discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it. Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes approximately 7,400 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics and top 20 in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report’s “Best Children’s Hospitals” ranks Mount Sinai Kravis Children's Hospital among the country’s best in several pediatric specialties. The Icahn School of Medicine at Mount Sinai is ranked No. 14 nationwide in National Institutes of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek’s “The World’s Best Smart Hospitals” ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally.

The Mount Sinai Health System is an equal opportunity employer. We comply with applicable Federal civil rights laws and does not discriminate, exclude, or treat people differently on the basis of race, color, national origin, age, religion, disability, sex, sexual orientation, gender identity, or gender expression. We are passionately committed to addressing racism and its effects on our faculty, staff, students, trainees, patients, visitors, and the communities we serve. Our goal is for Mount Sinai to become an anti-racist health care and learning institution that intentionally addresses structural racism.”

EOE Minorities/Women/Disabled/Veterans

Compensation

The Mount Sinai Health System (MSHS) provides a salary range to comply with the New York City Law on Salary Transparency in Job Advertisements. The salary range for the role is $28.1279 - $34.2649 Hourly. Actual salaries depend on a variety of factors, including experience, education, and hospital need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.