What are the responsibilities and job description for the PAYER ENROLLMENT SPECIALIST position at Premier Health?
A / R Services
FT / Days / 80 hours per pay
General Summary / Responsibilities :
Responsible for managing the credentialing and payer enrollment process for providers, offices, and groups by
completing third party insurance applications and contracts. Develops and maintains physician and group profiles
and data bases. Preparation and submission of all third-party provider applications and contracts. The position will
function as a resource and primary contact for payer enrollment related questions and issues between offices, and
third-party insurance companies. Responsible for monitoring and follow up of credentialing claim holds and denials.
Qualifications
Education
Minimum Level of Education Required : High School completion / GED
Additional requirements :
Type of degree : N / A
Area of study or major : N / A
Preferred educational qualifications : Business or Computers with experience in health care
billing, reimbursement, and / or contracting
Position specific testing requirement : N / A
Licensure / Certification / Registration
List any Licensure / Certification / Registration required by the position. Please see Lawson Code
Reference Sheet.
Experience
Minimum Level of Experience Required : 1 - 3 years of job-related experience
Prior job title or occupational experience : A minimum of one year experience in Credentialing / Payer
Enrollment
Prior specific functional responsibilities : Qualified candidates will have knowledge of, and some
experience with third party credentialing process.
Preferred experience : 3 years’ experience with medical billing is preferred
Other experience requirements : Proficiency in Microsoft Word and Excel. Cactus or similar Database
Knowledge / Skills
Demonstrated proficiency in Microsoft Word, database management and basic computer
knowledge. Knowledge of medical terminology. Possess good communication skills (writing and
verbal), diplomacy, tact, attention to detail and problem-solving skills. Must be able to work with all
levels of the organization which includes practitioners, administration and hospital staff.
Coordinate, organize, prioritize, and handle multiple projects with many disruptions. Highly
motivated and able to work independently in a high-volume department. Willingness to adapt to
flexible work schedules. Loyal, reliable, tactful, honest and discreet, maintaining confidentiality at
all times. Exhibit professional appearance and demeanor.
