Facility Enrollment Specialist

Facility Enrollment Specialist St. Luke's Health System - 3.5 Boise, ID Job Details Full-time 11 hours ago Qualifications Project reporting Medicare Provider database maintenance for medical credentialing Provider enrollment for medical credentialing Medical billing and coding coordination with healthcare providers Medicaid health insurance Medical billing discrepancy resolution Bachelor's degree Medicare regulations Centers for Medicare and Medicaid Services (CMS) Healthcare provider information Insurance claim issue resolution Medicaid regulations Medicaid Insurance provider collaboration Cross-functional collaboration Project stakeholder communication Entry level Under 1 year Full Job Description At St. Luke's, we pride ourselves on fostering a workplace culture that values diversity, promotes collaboration, and prioritizes employee well-being. Our commitment to excellence in patient care extends to creating an environment where our team can thrive both personally and professionally. With opportunities for growth, competitive benefits, and a supportive community of colleagues, St. Luke's is truly a great place to work. Under close supervision, the Facility Enrollment Specialist is responsible for the enrollment of facilities and providers for both government and commercial payers. Assists revenue cycle, facilities, and providers with accurate enrollment to maintain billing compliance. Advises revenue cycle teams, providers, and clinical leaders on matters related to enrollment, claims processing, and reimbursement.

What You Can Expect:

Oversees payer enrollment and maintenance of St Luke's facilities, including but not limited to reenrollment, address changes, credentialing, and new services. Oversees out of state Medicaid enrollment of St Luke's providers. Monitor provider directories at network, health system and payor insurance websites. Maintains basic knowledge of Medicare, Idaho Medicaid, out of state Medicaid, and commercial enrollment requirements, as well as federal, state, and local enrollment compliance and regulations. Fosters positive working relationships with commercial payors, state and federal. With basic billing knowledge, can navigate hospital based and provider-based claims and resolve billing edits. Identify and escalate any risks or delays that may impact revenue cycle operations. Provide regular updates to leadership and providers on enrollment status, potential delays, and projected completion dates. Attend working groups as delegate of the enrollment team. Works with and advises revenue cycle, providers, clinical leaders, CVO, information technology and more to resolve billing issues. Other duties and responsibilities as assigned.

Qualifications:

Education:

Bachelor's Degree or experience in lieu of degree

Experience:

No relevant experience required