Payer Enrollment Specialist - Managed Care

Posted:
6/25/2024, 5:00:00 PM

Location(s):
Kalispell, Montana, United States ⋅ Montana, United States

Experience Level(s):
Junior ⋅ Mid Level

Field(s):
Customer Success & Support

Job Description Summary:

Assists in contract management tasks to ensure completeness and compliance with applicable policies and regulatory requirements. Provides organization-wide support to ensure Logan Health system contracts, properties leased and owned are entered in the database system.

Qualifications:

  • Minimum of three (3) years administrative experience required.  Experience working with complex administrative support tasks preferred.
  • Proficient with Microsoft Office Suite and possess ability to learn other software as needed required.
  • Possess knowledge and understanding of data entry and retrieval skills preferred.
  • Demonstrated ability to work with complex documents and possess knowledge of commonly-used concepts, practices and producers for contract management.
  • Excellent organizational skills, detail-oriented, a self-starter, possess critical thinking skills and be able to set priorities and function as part of a team as well as independently.
  • Commitment to working in a team environment and maintaining confidentiality as needed.
  • Excellent verbal and written communication skills including the ability to communicate effectively with various audiences.
  • Excellent interpersonal skills with the ability to manage sensitive and confidential situations with tact, professionalism, and diplomacy.

Job Specific Duties:

  • Assists in the day to day tasks to include, but may not be limited to; document preparation, amendments, report preparation, special projects, etc.
  • Assists in the management of leases, contracts, and associated documentation including, but not limited to; entry of documents and all relevant information into the designated database, interacts with appropriate personnel for document review related to renewal, amendment, etc.
  • Assists in the development and administration of instructions and guidelines for document management.
  • Assists in the review of submitted documents for completeness, execution and retrieves additional information to ensure completeness. Provides assistance with lease, contract and/or property database management for Administration.
  • Assists with the entry of leases, property purchase documents, and property closing files into the designated database.  Interacts with appropriate personnel for contract review related to renewal, amendment and/or other aspects of property management.
  • Assists with the preparation and uploading of documents for the IRO annual audit.
  • Assists in the oversight and maintains the Arrangement Covered Persons and users in Compliance 360.
  • Interacts and communicates professionally with facility owner, tenants and vendors with regard to property related interactions.
  • Provides coverage to all areas of department as needed and assists with projects as assigned.  Duties may pertain to all or specific department functional areas:
  • Supports contract processes which include, but may not be limited to; assists with audits of the contract tracking system, ensures contract go through the proper process per LH policy, assists in the property management function for principally non-hospital facilities.
  • Supports compliance processes which include, but may not be limited to; assists in obtaining, maintaining and tracking payer certifications for providers and/or facilities, ensures contracted providers are credentialed and enrolled with third party payers, responsible for re-credentialing activities required by payers

The above essential functions are representative of major duties of positions in this job classification.  Specific duties and responsibilities may vary based upon departmental needs.  Other duties may be assigned similar to the above consistent with knowledge, skills and abilities required for the job.  Not all of the duties may be assigned to a position.

Maintains regular and consistent attendance as scheduled by department leadership.

Shift:

Day Shift - 8 Hours (United States of America)

Schedule Details:

Please know schedules and shifts are subject to change based on patient care and department/organizational needs.

Schedule:

Logan Health operates 24 hours per day, seven days per week.  Schedules are set to accommodate the requirements of the position and the needs of the organization and may be adjusted as needed.

Notice of Pre-Employment Screening Requirements

If you receive a job offer, please note all offers are contingent upon passing a pre-employment screening, which includes:

  • Criminal background check

  • Reference checks

  • Drug Screening

  • Health and Immunizations Screening

  • Physical Demand Review/Screening

Equal Opportunity Employer

Logan Health is an Equal Opportunity Employer (EOE/AA/M-F/Vet/Disability). We encourage all qualified individuals to apply for employment. We do not discriminate against any applicant or employee based on protected veteran status, race, color, gender, sexual orientation, religion, national origin, age, disability or any other basis protected by applicable law. If you require accommodation to complete the application, testing or interview process, please notify Human Resources.