Payor Enrollment Analyst - Temporary bei BayCare Clinic

Come work where passion, quality, vision, professionalism, and synergy are valued! BayCare Clinic's mission is to provide measurably superior specialty medical services to our patient        

BayCare Clinic Corporate Headquarters is looking for a temporary Payor Enrollment Analyst in Green Bay, WI. We’re looking for a detail oriented, thoughtful candidate who wants to contribute to a positive experience for all our patients. This role is a 12-week position, 40 hours per week, between our core hours, Monday-Friday between 8:00 a.m. - 5:00 p.m. This position has remote opportunity, however, does have limited on-site requirements. No Holidays! No Weekends!    

The Clinic:           

BayCare Clinic is a successful, dynamic group comprised of 19 specialties. We are a physician-owned entity with joint ownership in Aurora BayCare Medical Center, a 167-bed hospital located in Green Bay, WI, offering us a built-in referral base. Each of our specialty practices have clinical autonomy and are financially sound.           

BayCare Clinic offers part-time and full-time employees a comprehensive benefits package including health, dental, disability and life insurance, as well as flexible spending options. We also offer a 401k retirement plan with a company match, generous PTO, and paid holidays.          

The Team:           

The unique skills and talents of each member of our team contributes to our synergy and our overall goal of providing our patients with excellent care. We believe in the power of a positive, collaborative culture, and we strive to provide a supportive and energizing work environment.           

Every member of our team has a voice and is trusted to have ownership over their work. To encourage this, we provide regular opportunities for professional development, we seek out feedback and ideas, and we invite participation on a variety of projects.           

The Job:       

• Receives information regarding new practitioners from Provider Relations, practice sites, Compliance, and Patient Accounts, which includes all mail, email and faxes received from payors
• Enters provider information into enrollment databases such as PECOS and/or various enrollment portals and ensures that the information in the databases is current and accurate.
• Regularly reviews and edits provider CAQH records and verifies that all pertinent elements are captured in the databases and that it matches what is captured in the credentialing database.
• Responsible for the timely completion of complex government and commercial payer enrollment applications for all states and practice locations.
• Prepares initial and/or re-enrollment application packets, on behalf of the provider.
• Ensures the enrollment packets are appropriately signed, complete and accurate, and submitted to payor with necessary attachments.
• Coordinates re-enrollment dates and sends out application packets for all providers who require re-enrollment.
• Tracks all steps taken in the enrollment process and logs the actions in the credentialing database.
• Assists in the development and refinement of the monthly delegated credentialing roster files they sent to payors.
• Analyzes the monthly payor roster files for completion and accuracy prior to submission to the payors.
• Partners with Payor Enrollment Specialists/Assistants to achieve Clinic-wide and inter-departmental goals related to payor enrollment.
• Coordinates corrections/updates to the credentialing database with Provider Relations and IT as identified and as necessary.
• Monitors the pending credentialing claim report and takes any necessary action (which may include sending additional enrollment applications to the payor) to allow claims to be submitted for payment.
• Completes AO signature tasks in a timely manner.
• Communicates with various payors, practice sites, Provider Relations, Patient Accounts, providers, Compliance, and leadership regarding the status of enrollments on an ongoing basis as the primary contact for all enrollment issues.
• Enters payor Provider Identification Numbers (PINs) and the effective date into the credentialing database once they are received.
• Communicates with manager on an ongoing basis as to status of payor contracts and other various enrollment issues. 
• Enrolls and maintains physician/provider membership in all necessary managed care organizations and payor programs as required. 
• Engages payors and works to investigate and resolve issues related to payor enrollment brought forth by internal business partners.
• Participates in the physician/provider orientation process.
• Respects and maintains confidentiality.
• Works in a safe, compliant and ethical manner at all times.

The Requirements:

• Bachelor’s degree preferred.
• 4-5 years of payor credentialing experience; certification a plus.
• Strong working knowledge of Microsoft Office is necessary.
• High level of understanding of physician billing necessary.
• Excellent organizational skills to promote the efficient function of the provider enrollment process.
• Able to understand, analyze and interpret complex documents.
• Excellent interpersonal, communication, and problem-solving skills needed.
• Must have exceptional attention to detail.