Payor Application Spec

Description

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Summary:
The Payor Application Specialist is responsible for the accurate and timely completion of applications including all necessary EPIC work to a variety of payor reimbursement vendors for all clinicians providing service to the Physician Practices of the organization. This includes both new clinicians and renewals of credentialing and enrollment as needed for timely payment/reimbursement.

Responsibilities:

1. Adheres to all departmental and organizational policies listed in the team member handbook and the organization's Intranet, accurately uses the Kronos system to record incoming and outgoing work hours, reports and records any exceptions to supervisor and displays the qualities defined by AIDET, ACTIONS and the Pardee Pillars which results in an individual dedicated to excellent customer service, strong team and co-worker relationships and a positive, professional image.

2. Implements the physician enrollment and credentialing process for vendors who request provider enrollment services. Maintains the timelines on enrollment/credentialing schedules, communicates with providers and other departments to update as needed, clarify carrier information requirements and maintain strict level of confidentiality for all matters pertaining to provider credentials. Reviews new client packet to determine any enrollment issues.

3. Responds to internal and external inquiries on routine enrollment and contract matters, Monitors and advises clients on license expiration, works collaboratively with all necessary departments in relation to enrollment and credentialing specifications.

4. Develops and maintains all necessary enrollment documentation for clinicians providing services to all Pardee/UNC entities, works collaboratively with all Pardee/UNC within credentialing and enrollment specific matters including EPIC areas.

5. Participates in the day-to-day implementation and optimization, in collaboration with Pardee Hospital and Network leadership overall, of Epic Optimization opportunities. Performs all other duties as assigned.

Other information:
01.9050.7902

Legal Employer: Pardee - HCHC

Entity: Pardee UNC Health Care

Organization Unit: Patient Accounting

Work Type: Full Time

Standard Hours Per Week: 40.00

Work Assignment Type: Onsite

Work Schedule: Day Job

Location of Job: PARDEESUPP

Exempt From Overtime: Exempt: No

Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.