Payer Enrollment & Privileging Specialist

Company: Kelly Services
Location: Austin
Posted on: April 9, 2021

Job Description:

Kelly Services is currently seeking Payer Enrollment & Privileging Specialist for one of our top medical customers in Austin, TX Zipcode: 78746 Pay Rate:--$ 17.00 ----Working Hours: 7am-8:30am and work an 8 hour shift.Training 8am - 4:30pm Monday - Friday--Position is remote to start but will require them to be in the office at some point once office is back to open.Duration: Possible contract to hireResponsibilities: Collaborates with a third party/external payers and facilities/privileging agent to ensure both payer enrollment & privileging process is completed as required. Ensures all provider enrollment & privileging verification is performed in accordance with regulatory and accreditation standards as well as internal FMCNA policy and procedure. Performs audits of both the internal FMCNA Provider Database and FMCNA provider information compiled by the external payer and facility credential verification agent to ensure that credential verification is completed in a timely manner according to all regulatory and company requirements.PRINCIPAL DUTIES AND RESPONSIBILITIES:--- Under limited supervision, applies considerable payer enrollment & privileging knowledge to perform a broad range of tasks which include but are not limited to------ Contacts are frequently with individuals representing other departments, and/or representing outside organizations. Contacts involve obtaining or providing information or data on matters of moderate importance to the function of the department or which may be of a sensitive nature.--- May escalate issues to supervisor for resolution, as deemed necessary.--- Performs provider/practitioner payer enrollment & facility privileging tasks to completion by completing necessary applications, documentation, and gathering the needed information to ensure the provider/practitioner secures privileges and participation.--- Utilizes knowledge regarding national accreditation standards, internal medical staff bylaws and other related policies and regulations to perform functions pertaining to the provider/practitioner privileging process for the FMS Division. This includes but is not limited to:o Completing and processing all initial and re-credentialing payer & facility privileging applications for new providers/practitioners and credential verification applications for existing providers/practitioners in a timely and accurate mannero Conducting follow up as needed, acting as the primary liaison for FMCNA locations, practitioners, and the FMCNA third- party privileging agent to ensure that all enrollment & privileging is completed within the required timelines and that each provider/practitioner meets federal and state regulations as well as FMCNA internal requirementso Maintaining and updating the database on individual provider/practitioner enrollment & privileges' status, tracking pending/completed applications, and maintaining a complete and accurate database of historical applications. Provides regular reports and updates to pertinent FMS field operations management and Director Operations Monitoring.o Communicating with practitioners regarding payer & facility status, providing updates and obtaining additional information as required.o Update practitioner CAQH profile online or any additional NCQA primary source verifications upon initial credentialing for both payer or facility, as needed--- Educates and informs FMS field staff responsible for reporting new practitioners regarding their responsibilities in the payer & privileging process. Explains the payer & privileging requirements, practitioner specific information, regulations and industry standards for privileging of health care providers and other information as applicable--- Continually audits and analyzes the privileging process to identify deficiencies in controls and to identify process/workflow issues recommending improvements to manager and implementing if approved.--- Review internal Provider Database information and database of FMCNA provider information to take appropriate action where required to correct areas inaccurate data on re-credentialing and effective dates for payers & facilities or any other data point, such as license expirations, malpractice expirations, etc to ensure data integrity--- Responsible for generating various standard and ad hoc reports from database:o Prepares project status reports as required, detailing progress of credential verification status of individual practitioner credential applications for each FMS Division, and reporting variances and trends in the privileging process as identified to the Director Operations Monitoring.o Prepares reports detailing credential verification issues to pertinent field staff and credential verification agento The monthly provider/practitioner payer & privileging status report for review by Director Operations Monitoring.--- Review and comply with the Code of Business Conduct and all applicable company policies and procedures, local, state and federal laws and regulations.--- Assist with various projects as assigned by direct supervisor.--Qualifications: --- High School Diploma required; Associate's Degree desirableEXPERIENCE AND REQUIRED SKILLS:--- 2 - 4 years' related experience in credential verification, facility privileging, or in a Physician practice/Medical office or other similar experience in a healthcare setting preferred.--- Strong detail orientation required, with the ability to administer multiple tasks and prioritize.--- Excellent verbal and written communication skills.--- Ability to positively interact with Providers, hospital personnel, and other internal and external contacts.--- Perform work at a high level of accuracy and timelines.--- Attention to confidentiality and regard for protecting confidential and sensitive information--- Advanced level skills with Microsoft Access, Excel, and Word.--- Strong problem solving and time management skills with the ability to consistently work in a fast-paced environment.Strong Excel, data-base management, and document storage and management skills--Position is a contract to start with possibility of becoming permanent in the future based on business need and candidate performance. Position is working with credentialing physicians and ensuring they have privileges for visiting hospitals where the patients are at.Looking for a candidate that can project manage and follow through the whole process. Need someone that is task oriented and has ability to connect the dots. Candidate is going to be using 2 to 3 different databases at once. If they have InteliSoft (credentialing software) experience that would be a plus but if not we will train them on this software.. Hours for the first 2 weeks will be 8:00am-4:30pm for training and then after training, they can pick their start time----As a Kelly employee, you'll have access to world-class perks, including:

• Kelly-sponsored Affordable Care Act health care coverage available to eligible employees
• Group insurance options*
• Service bonus plan
• Holiday pay plan
• Weekly electronic pay options
• Online training campus that provides more than 3,000 free courses to help improve and develop skills
• Exclusive online employee community
• Employee assistance program available at no cost
• Corporate discounts
• Transportation Spending Accounts--*Offered and administered by EnrollVB. These plans are not sponsored by Kelly Services.It's a great opportunity to get your foot in the door and gain valuable experience so apply today!!**Important information:----This position is recruited for by a National Kelly Recruiter, not your local Kelly branch. Please submit your resume to be considered for this position by pressing the "SUBMIT RESUME" button below.Why Kelly--?You're looking to keep your career moving onward and upward, and we're here to help you do just that. Our financial staffing experts will connect you with premier companies for opportunities where you can learn, grow, and thrive. Jobs that fit your skills and experience, and most importantly, fit right on your path of where you want to go in in your career. It all adds up.About Kelly--At Kelly, we're always thinking about what's next and advising job seekers on new ways of working to reach their full potential. In fact, we're a leading advocate for temporary/non-traditional workstyles, because we believe they allow flexibility and tremendous growth opportunities that enable a better way to work and live. Connecting great people with great companies is what we do best, and our employment opportunities span a wide variety of workstyles, skill levels, and industries around the world.Kelly is an equal opportunity employer committed to employing a diverse workforce and providing accommodations for people with disabilities in all parts of the hiring process as required under its Employment Accommodation Policy. Kelly will work with applicants to meet accommodation needs that are made known to Kelly in advance.]]

Keywords: Kelly Services, Austin , Payer Enrollment & Privileging Specialist, Other , Austin, Texas