Insurance Enrollment Rep

Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advance technology. Capital Health is a five-time Magnet-Recognized health system for nursing excellence and is comprised of 2 hospitals. Capital Health Medical Group is made up of more than 250 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region.

Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates.

Minimum Pay:

$18.21

Position Overview

• Obtains licenses, certificates, and other necessary paperwork from providers whose professional component billing is done by the central billing office.
• Completes provider enrollment applications for all payers and attaches provider to group billing numbers for reimbursement to CH. Assists provider in completing applications to payers in a timely manner for billing and reimbursement to CH.
• Maintains current files of all provider information for the credentialing or re-credentialing process. Manages and maintains files of credentials in an effort to provide current documentation to third party payers to prevent uninterrupted cash flow to CH.
• Follows up with third party payers to facilitate insurance enrollment.
• Meets with newly hired or contracted providers in order to facilitate insurance enrollment process that billing office supports. Interacts with insurance representatives to facilitate and expedite the insurance enrollment process.
• Communicates enrollment process with providers, billing manager, and designated personnel of the organization.
• Assures insurance provider numbers are communicated to supervisors and managers for entry in IDX billing system.
• Completes timely follow-up of any CH provider enrollment issues based on spreadsheet timeline.
• Maintains departmental logs and spreadsheets for updating all insurance credentialing and re-credentialing.

MINIMUM REQUIREMENTS

• Education: High school diploma or equivalency.
• Experience: Previous credentialing knowledge while working in a physician office, hospital, or healthcare environment. Previous provider credentialing experience in a medical environment preferred. Medical billing experience preferred.
• Usual Work Day: 8 Hours

PHYSICAL DEMANDS AND WORK ENVIRONMENT

• Frequent physical demands include: Sitting , Standing , Walking , Keyboard use/repetitive motion
• Occasional physical demands include: Climbing (e.g., stairs or ladders) , Carry objects , Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Squat/kneel/crawl , Wrist position deviation , Pinching/fine motor activities
• Continuous physical demands include: Talk or Hear
• Lifting Floor to Waist 15 lbs. Lifting Waist Level and Above 10 lbs.
• Sensory Requirements include: Accurate Near Vision, Accurate Far Vision, Color Discrimination, Minimal Depth Perception, Minimal Hearing
• Anticipated Occupational Exposure Risks Include the following: N/A

Offers are contingent upon successful completion of our onboarding process and pre-employment physical. Capital Health will require all applicants to have an annual flu vaccine prior to start date, with the exception of individuals with medical and religious exemptions.

"Company will never ask candidates for social security numbers or date of birth during application phase. If you are asked for this information online, you may be a target for identity theft."

For benefit eligible roles, in addition to cash compensation, we provide a comprehensive and highly competitive benefits package, with a variety of physical health, retirement and savings, caregiving, emotional wellbeing, transportation, robust PTO plan, overtime to eligible roles, and other benefits, including "elective" benefits employees may select to best fit the needs and personal situations of our diverse workforce.

The pay rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining base salary and/or rate, several factors may be considered including, but not limited to location, years of relevant experience, education, credentials, negotiated contracts, budget, market data, and internal equity. Bonus and/or incentive eligibility are determined by role and level.

The salary applies specifically to the position being advertised and does not include potential bonuses, incentive compensation, differential pay or other forms of compensation, compensation allowance, or benefits health or welfare. Actual total compensation may vary based on factors such as experience, skills, qualifications, and other relevant criteria.