PHI Health
hospitality
ProviderEnrollmentSpecialist
“Provider Enrollment Specialist at PHI Health. Skills: provider enrollment, electronic data interchange (EDI), electronic funds transfer (EFT), electronic remittance advice (ERA), payer web portal requirements, payer policies, regulations, requirements, forms for multiple states, payer systems, on-line tools for managing the status of enrollments, electronic claims status, remittances, payments, clearinghouse activities, EMS licenses, HIPAA guidelines. develop, coordinate, implement and manage pr”
What You'll Achieve.
facilitate the prompt and accurate payment of submitted claims; facilitate the prompt flow of revenue in a compliant manner
Industry & Context.
trouble shooting
This position is designated Safety Sensitive for purposes of the Arizona Medical Marijuana Act.
What They're Looking For.
Must Have
High school diploma or GED equivalent required., Previous provider enrollment experience required., Knowledge of general office procedures and using office equipment., Demonstrated expertise in MS Office suite software.
What You'll Do.
develop, coordinate, implement and manage provider enrollment (PE), electronic data interchange (EDI), electronic funds transfer (EFT), electronic remittance advice (ERA) and payer web portal requirements with governmental and commercial payers., facilitate obtaining the appropriate signatures and verify application accuracy prior to submission., communication and interpersonal relationship development with payers both for initial enrollment and for managing changes brought about by regulatory requirements., navigate a myriad of payer systems to understand specific process requirements as well as utilize the specific on-line tools for managing the status of enrollments, electronic claims status, remittances, payments and clearinghouse activities., Serves as the initial contact for trouble shooting, monitoring document transmissions, and identifying opportunities for process improvements regarding government payers., Communicates and works closely with Patient Financial Services, Cash Posting, GE Billing Services, Operational and Compliance leadership and provide technical support to facilitate the prompt flow of revenue in a compliant manner., independently prioritize and process a high volume of work., identify and develop workflow processes to meet the ever-changing regulatory requirements, Request and organize supporting documentation to accompany various provider enrollment applications from multiple departments, Develop and maintain database of all EMS licenses for all base locations to assure consistency with submitted documentation., identify, develop and conduct audits of and for Provider Enrollment and Patient Financial Services., train on the complexities of payer and regulatory requirements., Communicate to management all changes in Medicare/ Medicaid/Tricare/HIS and all other federal payer enrollment requirements., Maintain the highest level of confidentiality at all times in accordance with HIPAA guidelines and PHI Group Inc.
and PHI Health, LLC policies., Adhere to all PHI Group, Inc.
and PHI Health, LLC policies and procedures., Demonstrate responsiveness and sense of urgency when dealing with payers and internal customers., Possess the ability to initiate and follow through on detailed regulatory requirements., Complying with Company HS&E policy and procedures., Responsible for supporting company Safety Management Systems activities., Understands and provides visible support of Destination Zero., Perform other duties as assigned.
How You'll Work.
Team & Collaboration
Works closely with Patient Financial Services, Cash Posting, GE Billing Services, Operational and Compliance leadership.; Provide technical support to facilitate the prompt flow of revenue in a compliant manner.; Request and organize supporting documentation from multiple departments, including but not limited to PHI Health, LLC and/or PHI Group, Inc. Corporate Operations, Corporate Compliance, Legal, Risk Management, Tax, Patient Financial Services, Aviation, Clinical and Financial Services.
Communication Scope
excellent communication skills
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