Payer Enrollment Coordinator III

Responsibilities

• Minimizes reimbursement barriers for patients and providers by assisting with determining coverage and access options available for a specific product.
• May assist healthcare providers with questions related to payer policies, patient assistance, and reimbursement support services.
• Solves moderately complex coverage and reimbursement issues that may create barriers to access for patients.
• Remains knowledgeable of private payer, Medicare, and Medicaid structure systems and reimbursement processes.
• Responds to all patient, nursing, and provider account inquiries.

Requirements

• Tracks and assigns practitioner applications for processing by payer enrollment specialist staff.
• Audits and monitors payer enrollment application/files processed by team members to ensure appointments are accurate and processed in the required timeframes.
• Collaborates with management to develop methods used in auditing applications for accuracy and metrics being measured.
• Ensures completion, quality, accuracy, and security of information in accordance with institutional guidelines.
• Provides input and develops staff to learn and make improvements continuously.
• Trains new and existing staff on processing payer enrollment applications and registrations.
• Serves as the primary back up to payer enrollment staff and management.

Qualifications

• Associate's degree and 2 years of relevant experience required
• Or equivalent combination of education and experience