Overview
Preference to candidates with ENROLLMENT, CREDENTIALING, and/or BILLING experience.
As a patient-focused organization, University of Utah Health 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 seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA
The Provider Enrollment Specialist is responsible for obtaining and coordinating all necessary provider enrollment applications for billing to Medicare, Medicaid and Contracted Insurance Payers. Functionally, these activities are key to the maintenance of the physician group, individual physician records, regulatory, and hospital contract compliance.
Corporate Overview: The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for our academic research, quality standards and overall patient experience. Our five hospitals and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes.
Responsibilities
Essential Functions
Prepares documents necessary to enroll physicians and non-physician providers with insurance carriers.
Maintains deletions, additions, and changes to the Physician Enrollment file pertaining to all pertinent information including review of payer membership.
Handles telephone communications and written correspondence with providers and fiscal intermediaries in an efficient and effective manner that facilitates the Provider Enrollment process.
Maintains updated information per Insurance carrier requirements through contact with the carriers and by reviewing bulletins, and other materials sent to the providers.
Works in a team effort on projects such as new start-ups, renewals, re-credentialing applications as required by Insurance carriers.
Prepares documents in a consistent and accurate manner.
Communicates information to input into Cactus and Epic system including new providers and updates of provider information using the appropriate forms.
Responsible for working enrollment issues.
Responsible for working provider enrollment claims in Epic.
Follows department and Insurance payer guidelines for preparing documents in a consistent and accurate manner.
Reports any detected problems, errors, and/or changes in provider enrollment requirements, when discovered.
Understands and complies with department and organization policies and insurance carrier guidelines.
Other duties as assigned.
Knowledge / Skills / Abilities
Excellent written and verbal communication skills, customer service skills, including professional telephone skills.
Good organizational skills and the ability to pay attention to detail.
Self-motivated with good time management and organizational skills.
Ability to read and interpret basic to moderately complex documents such as operating and maintenance instructions, procedure manuals, and government/healthcare guidelines.
Qualifications
Required
Associate's degree in a related area of assignment, or equivalency.
Three years of experience in professional support.
Qualifications (Preferred)
Preferred
Provider Enrollment experience.
Ability to multi-task in a busy office environment.
Experience with Epic and Cactus system 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.
Physical Requirements
Listening, Near Vision, Sitting, Speaking
Multi-lingual Candidates Welcomed
To inquire about this posting, email: [email protected]
EEO Statement
University of Utah Health Hospitals and Clinics, a part of The University of Utah, values candidates who have experience working in settings with students and patients from all backgrounds and possess a strong commitment to improving access to higher education and quality healthcare for historically underrepresented students and patient populations.
All qualified individuals are encouraged to apply. Veterans’ preference is extended to qualified applicants, upon request and consistent with University policy and Utah state law. Upon request, reasonable accommodations in the application process will be provided to individuals with disabilities.
University of Utah Health Hospitals and Clinics, a part of The University of Utah, is an Affirmative Action/Equal Opportunity employer and does not discriminate based upon race, ethnicity, color, religion, national origin, age, disability, sex, sexual orientation, gender, gender identity, gender expression, pregnancy, pregnancy-related conditions, genetic information, or protected veteran's status. The University does not discriminate on the basis of sex in the education program or activity that it operates, as required by Title IX and 34 CFR part 106. The requirement not to discriminate in education programs or activities extends to admission and employment. Inquiries about the application of Title IX and its regulations may be referred to the Title IX Coordinator, to the Department of Education, Office for Civil Rights, or both.
To request a reasonable accommodation for a disability, please contact the University of Utah Health Hospitals and Clinics Human Resources office at 801-581-6500. If you or someone you know has experienced discrimination or sexual misconduct including sexual harassment, you may contact the Director/Title IX Coordinator in the Office of Equal Opportunity (OEO). More information, including the Director/Title IX Coordinator's office address, electronic mail address, and telephone number can be located at:www.utah.edu/nondiscrimination/
Online reports may be submitted atoeo.utah.edu/
The University is a participating employer with Utah Retirement Systems (“URS”). Eligible new hires with prior URS service, may elect to enroll in URS if they make the election before they become eligible for retirement (usually the first day of work). Contact Hospitals and Clinics Human Resources at (801) 581-6500 for information. Individuals who previously retired and are receiving monthly retirement benefits from URS are subject to URS’ post-retirement rules and restrictions. Please contact Utah Retirement Systems at (801) 366-7770 or (800) 695-4877 or Hospitals and Clinics Human Resources at (801) 581-6500 if you have questions regarding the post-retirement rules.
This position may require the successful completion of a criminal background check and/or drug screen.
Requisition Number 83691
Reg/Temp Regular
Employment Type Full-Time
Shift Day
Work Schedule M -F 8:00 - 5:00
Clinical/Non-Clinical Status Non-Clinical
Location Name Business Services Building
Workplace Set Up Remote
City SALT LAKE CITY
State UT
Department COR ISC 10Z PAYER REL&CONTRACT
Category Finance/Accounting
Workplace Set Up Remote
