What are the responsibilities and job description for the Provider Enrollment Rep position at Swedish American?
Pay Range : $20.56-$28.78 / hr
Additional components of compensation may include :
Evening & night shift differential
- Overtime
- On-call pay
Benefits information : https : / / careers.uwhealth.org / benefits /
At UW Health in northern Illinois, you will have :
POSITION SUMMARY :
The Provider Enrollment Representative is responsible for payor enrollment applications for all medical faculty, Advance Practice Practitioner, other clinical staff and groups for UW Health and related entities including Access Community Health Centers (ACHC). The provider enrollment representative is responsible for the timely completion of government, managed care and commercial payor enrollment applications, via paper or on-line records. Responsibilities include, but are not limited to, preparation of applications, follow up with providers to ensure form completion, verification of practice credentials, verification of application status with insurance carriers, review of internal edits to ensure appropriate follow up for missing enrollment information, review of provider data base (ECHO) and entry of provider information and tracking in the provider data base. The incumbent will work closely with providers, Medical Staff Affairs, UW School of Medicine and Public Health, Human Resources, Clinic Operations and Revenue Cycle team members to ensure providers are enrolled timely and accurately.
EDUCATION / TRAINING :
Minimum :
High School Diploma or equivalent
Preferred :
Associate's Degree in Accounting, Business, Health Information Management, or related field
LICENSURE / CERTIFICATION :
Minimum :
N / A
Preferred :
N / A
EXPERIENCE : Minimum :
1 year experience in an insurance, finance, medical office, or customer service field.
Preferred :
1 year experience with provider enrollment or provider credentialing
REQUIRED SKILLS, KNOWLEDGE, AND ABILITIES :
Ability to make good judgments in demanding situations
Ability to react to frequent changes in duties and volume of work
Effective communication skills
Ability to listen empathetically
Ability to logically and accurately organize details
Ability to manage multiple tasks with ease and efficiency
Self-starter with a willingness to try new ideas
Ability to work independently and be result oriented
Positive, can-do attitude coupled with a sense of urgency
Effective interpersonal skills, including the ability to promote teamwork
Strong problem-solving skills
Ability to ensure a high level of customer satisfaction including employees, patients, visitors, faculty, referring physicians and external stakeholders
Ability to use various computer applications including EPIC
Excellent PC operating skills (keyboard, mouse) and use of MS Office
Broad knowledge of health care business office practices and principles
Basic math skills and knowledge of general accounting principles
Maintains confidentiality of sensitive information
Knowledge of Business Office policies and procedures
Knowledge of local, state and federal healthcare regulations
Ability to set priorities and meet deadlines
Ability to stay calm under pressure and deal effectively with difficult people
MAJOR RESPONSIBILITIES :
Core Responsibilities :
Complete provider and group enrollment for UW Health and its affiliates
Successfully implement the entire enrollment process for all providers, adhering to all timelines while maintaining strict confidentiality for matters pertaining to provider credentials.
Coordinate credentialing data needed for enrollment (i.e., Medical Degree, Drug Enforcement Administration (DEA) number, state license number, Board certifications, CV, liability insurance, etc.).
Effectively communicate with staff, Department Assistants, and providers to ensure the timely completion of outgoing and incoming applications.
Maintain provider credentialing files electronically via provider enrollment software and CAQH (Council for Affordable Quality Healthcare).
Complete revalidation of previous enrolled providers and groups.
Communicate with insurance payers to resolve provider enrollment issues.
Release claims held due to pending enrollment completions and denial follow up as needed.
Customer Service Standards :
Support co-workers and engage in positive interactions.
Communicate professionally and timely with internal and external customers.
Demonstrate friendliness by smiling and making eye contact when greeting all customers.
Provide helpful assistance in anticipating and responding to the needs of our customers.
Collaborate with customers in planning and decision making to result in optimal solutions.
Our Commitment to Diversity, Equity, and Inclusion
UW Health is committed to being a diverse, inclusive and anti-racist workplace and is an Equal Employment Opportunity, Affirmative Action employer. Our integrity shines through in patient care interactions and our daily work practices as we work to embrace the knowledge, unique perspectives and qualities each employee and faculty member brings to work each day. Applications from Black, Indigenous and People of Color (BIPOC) individuals, LGBTQ and non-binary identities, women, persons with disabilities, military service members and veterans are strongly encouraged. EOE, including disability / veterans.
PI258232798
Salary : $21 - $29
