Provider Enrollment Analyst (Temporary for 9 months) - Remote - Nationwide at Vituity in Sacramento, California

Job Description:

Remote, Nationwide - Seeking Provider Enrollment Analyst (Temporary)

Everybody Has A Role To Play In Transforming Healthcare

If you want to be part of changing healthcare to better serve patients, you are in the right place. With Vituity you will join a team of individuals dedicated to our culture of caring and work to develop and implement innovative solutions, while tackling some of the healthcare industry's most challenging situations from the inside.

Join the Vituity Team. At Vituity, our core values matter. We embody a Culture of Caring by approaching every human interaction with compassion and heart. With a Servant Leadership philosophy, we focus on what we can accomplish when we put our patients and colleagues first. An Ownership Mentality means we all have mutual accountability to drive positive change for Vituity as a whole. Finally, our focus on Innovation enables all of us to re-imagine healthcare and bring about lasting change. Ultimately, we are unified around the common purpose of transforming healthcare to improve lives, and we believe everyone has a role to play in that. Help us shape the future of healthcare.

Vituity Locations: Vituity has opportunities at 450 practice locations across the country, serving 8 million patients a year. With Vituity, if you ever need to move, you can take your job with you.

The Opportunity

• Temporary position for 9 months.
• Generate, audit, and submit at least 130 recurring provider demographic rosters per month (over 1,500 rosters per year) for Blue Shield, Anthem Blue Cross, Cigna, United Healthcare, Multiplan, HealthNet, HealthSmart, and other payer programs throughout the country as needed.
• Work towards the team's overall goal of zero pending applications or roster submissions over six months after the Provider's start date.
• Submit all completed rosters to their respective supervisor or manager for audit, while working towards an error rate of less than 10% and no longer requiring audits.
• High focus on roster processes for payers and across the enterprise, including, but not limited to ad-hoc requests, credential verification, roster preparation, audits, submissions, and provider validations.
• Monitor submitted provider enrollment rosters to ensure they are processed and approved by payers and communicate said approvals to our billing team prior to timely filing.
• Complete any provider demographic, payer validations, or audits requested within payers' allotted timeframes or contracted terms.
• Develop understanding of how to tag, filter, build relationships, and remove items in DocGen Packages, within Salesforce, to assist the rest of the team by auto-populating required documents.
• Begin to learn how to build dashboards to assist the rest of the team with managing their workload.
• Manage daily administrative duties.
• Communicate data errors within our systems and notify the applicable stakeholders.
• Data entry in provider databases, such as Salesforce, CAQH, and Availity.
• Prioritize requests and manage time and workload to execute project plans within given deadlines.
• Monitor fax, email inboxes, and SharePoint mail for the Provider Enrollment Analyst sub-team.
• Comfortable with working remotely full-time with the ability to adapt and work independently with little guidance.
• Respond timely to internal and external inquiries on any provider or contract matter including, but not limited to, routine follow up with payers on pending rosters and individual or practice location demographic inquiries.
• Serve as liaison between our billing company, providers, and payer representatives for a multitude of purposes.
• Maintain a strict level of confidentiality for all matters pertaining to provider credentials and information.
• Focus on tracking data integrity for the Provider Enrollment team and bring any concerns to their respective supervisor and manager.
• Co-Design with colleagues and payer contacts so that ad-hoc demands are completed efficiently and painlessly.
• Terminate inactive providers from Blue Shield, Anthem Blue Cross, Cigna, United Healthcare, Multiplan, HealthNet, HealthSmart, and other payer programs throughout the country to remain compliant with federal and state regulations.
• Maintain SB-137 and No Surprises Act rosters to remain compliant with federal and state regulations.
• Ensure data integrity across internal departments and payer systems through recurring validations.
• Participate in trainings and development to mitigate compliance risk with state and federal regulations.
• Begin to research determine resolutions to various payer issues with an overall goal to lose no more than $100K in revenue per year.
• Support research, review, and testing of educational materials for organization growth.
• Ensure Salesforce reporting functions and settings are operating correctly teamwide.
• Update records in Salesforce with all pertinent information required for data integrity and historical tracking.
• Demonstrate extensive documentation in all databases (i.e., Salesforce, Wrike, SharePoint, Teams, etc.) for ongoing or open tasks.
• Ability to use Salesforce Dataloader for bulk data imports.

Required Experience and Competencies

• High School Diploma in combination with relative work experience required.
• 2-4 years related healthcare and/or data analytics experience required.
• Bachelor's degree is preferred.
• 3+ years of related healthcare and/or data analytics experience preferred.
• Knowledge of billing or reimbursement is desired.
• Provider Enrollment experience is desired.
• Proficient in Microsoft Office Suite (Word, Teams, SharePoint, Excel, Outlook, OneNote, OneDrive, PowerPoint, etc.).
• Ability to effectively interact with providers, payer representatives, internal departments, team members, and other stakeholders, both in written and verbal communication.
• Ability to accomplish tasks thoroughly and accurately.
• Ability to effectively organize and manage time.
• Ability to learn additional technology-based assistance (Teams, SharePoint, etc.).
• Ability to learn online enrollment systems, Identity & Access system, Counsel for Affordable Quality Healthcare system, Medicare enrollment specialties, and National Provider Identifier taxonomies.
• Salesforce experience is a plus, utilizing dashboards and reporting to develop internal preference for ongoing workload management.
• Ability to learn Medicaid enrollment processes (including revalidations, medical license expirations, deactivations, NPI taxonomy importance, how data flows to Medicaid managed cares, Medicaid billing manuals, state administrative codes, border state enrollment process, out of state enrollment process, etc.).
• Ability to learn Managed Care and Commercial enrollment processes.
• Ability to learn Delegated Credentialing processes.
• Ability to learn billing processes, including timely filing and claims denial reasons.
• Develop critical thinking skills and professional relationships.

The Community

Even when you are working remotely, you are an important part of the Vituity Community. We offer plenty of opportunities to engage with other Vitans through a variety of virtual meet-and-greets, events and seminars.

• Monthly wellness events and programs such as yoga, HIIT classes, and more
• Trainings to help support and advance your professional growth
• Team building activities such as virtual scavenger hunts and holiday celebrations
• Flexible work hours
• Opportunities to attend Vituity community events including LGBTQ+ History, Dia de los Muertos Celebration, Money Management/Money Relationship, and more.

Benefits & Beyond*

Vituity cares about the whole you. With our comprehensive benefits package, we are mindful of what matters most, and support your needs of today and your plans for the future.

• Superior health plan options
• Dental, Vision, HSA/FSA, Life and AD&D coverage, and more
• Top Tier 401(k) retirement savings plans that offers a $1.20 match for every dollar up to 6%
• Outstanding Paid Time Off: Four weeks' vacation, Paid holidays, Sabbatical
• Student Loan Repayment Program
• Professional and Career Development Program
• EAP, travel assistance and identify theft included
• Wellness program
• Commuter Benefits Program
• Diversity, Equity and Inclusion (DEI) initiatives including LGBTQ+ History, Dia de los Muertos Celebration, Money Management/Money Relationship, and more.
• Purpose-driven culture focused on improving the lives of our patients, communities, and employees.

Salary range for this role is $22.90 - $28.63 per hour. Please speak with a recruiter for more information.

We are unified around the common purpose of transforming healthcare to improve lives and we believe everyone has a role to play in that. We know that when we work together across sites and specialties as an integrated healthcare team, we can exceed the expectations of our patients and the hospitals and clinics we work in. If you are looking to make a difference, from clinical to corporate, Vituity is the place to do it. Come grow with us.

Vituity appreciates differences; our dedication to diversity, equity and inclusion is at the heart of our organization. Vituity does not discriminate against any person on the basis of race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information (including family medical history), veteran status, marital status, pregnancy or related condition, or any other basis protected by law. Vituity is committed to complying with all applicable national, state and local laws pertaining to nondiscrimination and equal opportunity.

*Benefits for part-time and per diem vary. Please speak to a recruiter for more information.

Applicants only. No agencies please.