University of Utah Health Provider Enrollment Specialist in SALT LAKE CITY, Utah
As a patient-focused organization, the University of Utah Health Care exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health Care seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, diversity, integrity, quality and trust that are integral to our mission. EO/AA
This position facilitates the centralized enrollment program and system wide practitioner enrollment database and serves as the primary enrollment liaison for hospitals, clinics, payer, billing office, and practitioner related issues.
Receives information regarding new practitioners from departments, Medical Staff Office, and billing offices.
Enters practitioner information into databases (enrollment software) and ensures that information in the databases is current and accurate. Regularly edits provider records and verifies that all pertinent elements are contained in the databases and that it matches what is captured in Cactus (the Credentialing database).
Sends initial and re-enrollment application packets to practitioners or School of Medicine Departments.
Creates and maintains practitioner files in enrollment database, and enrollment paper files.
Completes application packet, on behalf of the practitioner, for those payers who require a paper enrollment application.
Receives back the initial or re-enrollment applications, ensures they are appropriately signed, assuring completeness, enters data into the enrollment software and submits to payer with necessary attachments.
Coordinates re-enrollment dates and sends out application packets for all practitioners who require re-enrollment.
Receives back the re-enrollment applications, ensures they are appropriately signed, assuring completeness, enters data into the enrollment software and verifies any new or changed information.
Tracks all steps taken in enrollment process and logs the actions in the software.
Monitors EPIC Claim Edit and Charge Review and takes the necessary actions (which may include sending an initial enrollment application to the practitioner and payer) to clear edit so that a "clean" claim may be submitted for payment.
Communicates with School of Medicine, UNI, Community Clinics, billing offices, practitioners, and payers regarding status of enrollment on an ongoing basis as the primary contact for all enrollment issues.
Assembles a biweekly update in which we report Hospital Board approvals and changes to practitioner information to delegated payers. Changes in information are also submitted to payers that require paper applications (this process is similar to the initial enrollment process).
Prepares practitioner profile and submits to delegated payers using the biweekly update.
Enters payer Provider Identification Numbers (PINs) into EPIC SER once they are received.
Will communicate with Medical Staff Office on an ongoing basis as to status of delegations, approvals, and other various credentialing and enrollment issues.
Knowledge / Skills / Abilities
Experience with Word, Excel, Outlook, and use of data management systems.
Demonstrated human relation and effective communication skills.
Experience with EPIC and Intellisoft applications.
Must demonstrate the ability to work independently, resolve issues, pay attention to detail.
Ability to adhere to strict deadlines.
Associates degree in a related area of assignment or equivalency.
Three years experience as professional support.
- Experience with EPIC and Cactus applications.
Working Conditions and Physical Demands
Employee must be able to meet the following requirements with or without an accommodation.
- This is a sedentary position that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions.
Requisition Number 25838
Employment Type Full-Time
Work Schedule 8:00 - 5:00
Location Name Business Services Building
Patient Care? No
City SALT LAKE CITY
Department UUH ISC 10Z PAYER REL&CONTRACT
The University of Utah Health Care is an Affirmative Action/Equal Opportunity employer. Upon request, reasonable accommodations in the application process will be provided to individuals with disabilities. The University of Utah Health Care is committed to diversity in its workforce. Women and minorities are encouraged to apply.