Massachusetts Jobs

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.

Job Type:

Regular

Scheduled Hours:

40

Work Shift:

Day (United States of America)

Job Description:

• Schedule: M-F, Business Hours, Remote or Hybrid option

Under the direction of the Manager, Provider Enrollment and Reporting, the government payer enrollment specialist is responsible for the enrollment of both individual providers and groups/locations with non-commercial payers (Medicare, Medicaid).

The provider enrollment process ensures that the appropriate provider enrollment numbers are obtained for both individual providers and groups/locations enabling the organization to bill provider charges in a timely manner and ensure clinicians have the ability to order, refer, and prescribe as necessary. This includes initiating the enrollment process from notification that a new individual providers or groups/locations will be added to the network and collaborating with multi-disciplinary on-boarding group and the practitioner to complete the application process.

Primary Responsibilities:

• Serve as the primary point for all data entry into the BILHPN database as it relates to responses from the health plans. Load all rosters into the database to ensure accuracy. (essential)

• Assist the Enrollment team with scanning all paper files into an electronic database and shredding of paper files. (essential)

• Maintain accuracy and completeness of BILHPN database in accordance with uniform nomenclature. (essential)

• Ensure that provider participation in the health plans is current and accurate for publication in the health plan websites, Find A Doctor website, the Beth Israel Deaconess Medical Center Referral Guide and the BILHPN Provider Directory. Upon receipt of approval, the enrollment assistant will verify via the plan website the accuracy of the submitted application. (essential)

• Maintain the Enrollment electronic mailbox with assistance from Senior Enrollment staff on an as needed basis (essential)

• Contact the insurance companies for follow up on outstanding enrollments. (essential)

• Assists in department projects as needed. (essential)

Required Qualifications:

• High School diploma or GED required.

• 0-1 years related work experience required in Data Entry related experience..

• Experience with computer systems required, including web based applications and some Microsoft Office applications which may include Outlook, Word, Excel, PowerPoint or Access.

Preferred Qualifications:

• Knowledge of Medicare, Medicaid and health plan credentialing, re-credentialing and enrollment process; licensure requirements and regulations of various agencies such as the board of Registration in Medicine, American Board of Medical Specialties and Individual Specialty Boards preferred normally acquired through related work experience.

FLSA Status:

Non-Exempt

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) and COVID-19 as a condition of employment. Learn more (https://www.bilh.org/newsroom/bilh-to-require-covid-19-influenza-vaccines-for-all-clinicians-staff-by-oct-31) about this requirement.

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Equal Opportunity Employer/Veterans/Disabled