University of Rochester
Healthcare
PayerEnrollmentCoordII
“Payer Enrollment Coord II at University of Rochester. Skills: Payer enrollment, Provider enrollment, Application processing. Assist with determining coverage. Assist healthcare providers with questions”
Industry & Context.
Resolve issues
What They're Looking For.
Must Have
1 year of relevant experience, Associate's degree
What You'll Do.
Assist with determining coverage
Assist healthcare providers with questions
Resolve coverage and reimbursement issues
Remain knowledgeable of payer systems
Respond to patient inquiries
Respond to nursing inquiries
Respond to provider inquiries
Determine practitioner eligibility
Complete paper applications
Complete electronic applications
Process government payer applications
Process commercial payer applications
Complete revalidation applications
Complete new enrollments
Perform updates for enrolled APPs
Submit applications securely
Communicate status of files
Coordinate electronic submission
Coordinate paper applications
Analyze application accuracy
Analyze application completeness
Set up new University groups
Ensure files are completed accurately
Ensure applications are completed accurately
Ensure revalidations are completed accurately
Document provider enrollment status
Track provider enrollment status
Maintain provider information
Complete claim entry system enrollment
Coordinate transfer of data
Coordinate electronic information transfer
Obtain information from providers
Obtain information from department representatives
Secure provider signatures
Secure authorized official signatures
Communicate applicant status
Coordinate efforts to obtain information
Notify providers of approval
Notify department representatives of approval
Assist APPs with CAQH profiles
Ensure compliance with standards
Ensure compliance with policies
Respond to inquiries from organizations
Interface with internal customers
Interface with external customers
Represent department in initiatives
Represent department in meetings
Serve as primary back up
Serve as Team Peer Interviewer
How You'll Work.
Team & Collaboration
Work with team leaders; Work with staff; Collaborate with providers; Collaborate with department representatives; Collaborate with other departments; Interface with internal customers; Interface with external customers
Communication Scope
Communicate status; Communicate applicant status; Notify providers; Notify department representatives
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