Payer Enrollment Specialist

Posting Title: Payer Enrollment Specialist Overview:

Fast Pace Health strives to provide a best in class patient experience in every interaction. We are seeking a highly-skilled, experienced Payer Enrollment Specialist to join our growing team. Our ideal candidate will be deeply committed to nurturing our Fast Pace mission of teamwork, communication, empowerment and quality care in a friendly and encouraging environment.

Fast Pace Health aims to push for a new vision of healthcare in rural communities that will consist of an array of different services. We are changing the delivery of healthcare in these rural areas by integrating excellent patient care, education, accessibility, and community service, in a way that puts the patients needs first and improves the health status of our communities.

In a way, that best supports our values, the individual is responsible for the daily activities of credentialing and payor enrollment processes for Fast Pace. The Payer Enrollment Specialist will play an important role in leading, coordinating, monitoring, and maintaining the payer enrollment process. The Payer Enrollment Specialist facilitates all aspects of Fast Paces credentialing, including initial provider enrollments, reassignments, and maintenance updates, as well as the enrolling of providers for health plan clients. The Payer Enrollment Specialist ensures interpretation and compliance with the appropriate accrediting and regulatory agencies, while developing and maintaining a working knowledge of the statues and laws relating to credentialing and payer enrollment.

Fast Pace Health is a growing company! You will have the support and mentoring you need to become the best Payer Enrollment Lead you can be! We will help you grow your clinical competencies, and can offer you a rewarding career path. We work as a dynamic team to surpass our business goals by ensuring our patients receive the best care possible in a positive environment.

We offer competitive compensation and benefits such as holiday pay, PTO, medical, dental, vision and Work-Life balance, to name a few.

As a Fast Pace Health employee you will have the opportunity to participate in community events and outreach programs. This includes, but is not limited to, seasonal parades, book drives, festivals, trunk or treating, fun runs, and more. We dress up for holidays and celebrate with pot lucks. At Fast Pace, our community is our family, and we are a family first community.

Essential Functions:

1. Obtains, verifies, and analyzes all required information pertinent to payer enrollment.
2. Organize the payer enrollment process to meet the required timelines.
3. Interfaces with health plan contacts to understand and support the credentialing application and completion process.
4. Prepare, submit and track payer enrollment applications, re-credentialing and demographic updates to payers
5. Performs ongoing follow-up with payers to ensure completeness of payer applications
6. Ensure ongoing accuracy and completeness of providers CAQH.
7. Participates with the team to implement and adhere to policies, procedures, and systems to ensure timely data entry and enrollments in payer enrollment system.
8. Ensures adherence to objectives, operating policies and procedures, and strategic action plans for achieving goals.
9. Collaborate with Group Enrollment Supervisor to create new processes and procedures as needed to improve overall process.
10. Communicates with Group Enrollment Supervisor and other Management to resolve payer enrollment issues
11. Responsible for learning the aspects of compliance in the company by completing all mandatory compliance training.
12. The ability to maintain friendly, cordial relations with fellow coworkers.
13. The ability to build and maintain confidence and credibility with fellow coworkers.
14. The ability to maintain friendly, cordial relations with all clients and employees; maintain a positive work atmosphere by acting and communicating in a manner that results in a positive work relationship with customers, co-workers and managers.
15. The ability to perform the physical, use of senses, cognitive, and environmental functions of the position, as specified on the physical demands.
16. Ability to comply with Company standards of operations.
17. Ability to adhere to the Core Values of the Company, of teamwork, communication, empowerment, quality of care, and friendliness.
18. The ability to promote and maintain a respectful culture of employee, employer and business confidentiality.
19. Perform other duties as assigned by management.

Education : High School Diploma or its equivalent

AND

Experience:

• Previous experience in payer enrollment
• Experience in use of the Council for Affordable Quality Healthcare (CAQH), PECOS and other payer enrollment portals
• Ability to use computer systems including but not limited to Word, Excel, and credentialing software
• Excellent organizational skills
• Strong customer service approach
• Attention to detail
• Ability to work independently

Fast Pace Health is committed to the principle of equal employment and creating an inclusive environment for the benefit of our employees, our patients, and our communities. We are an equal opportunity employer and welcome job applications from qualified individuals without regard to race, creed, color, ancestry, religion, sex, sexual orientation, gender identity, pregnancy, national origin, age, disability, veteran status, marital status, parental status, genetic information or any other legally protected characteristics or conduct.
Please refer to the links below for information regarding your rights under certain federal laws:

Mississippi Residents Only:
In Mississippi, Fast Pace requires pre-employment/drug/alcohol testing as a condition of employment. The law requires that Fast Pace notify applicants, in writing, upon application and prior to the collection of the specimen for drug and alcohol test, that they may be tested for the presence of drugs (or alcohol) in their metabolites. Miss. Code. Ann. 71-7-3(5).

Applicants are limited to individuals from states, excluding the following: California, Colorado, Hawaii, Illinois, New Jersey, New York, Rhode Island, Washington, and the District of Columbia.