Insurance Enrollment Rep - FT - Day - Credentialing Lawrenceville NJ

Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a dynamic health care resource accredited by the DNV that includes two hospitals, an outpatient center, satellite ED, and an expansive network of primary and specialty care. Capital Health Medical Group is made up of more than 600 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region.

Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates.

The listed pay range or pay rate reflects compensation for a full-time equivalent (1.0 FTE) position. Actual compensation may differ depending on assigned hours and position status (e.g., part-time).

Pay Range:

$18.57 - $23.23

Scheduled Weekly Hours:

40

Position Overview

• Obtains licenses, certificates, and other necessary paperwork from providers whose professional component billing is done by the central billing office.
• Completes provider enrollment applications for all payers and attaches provider to group billing numbers for reimbursement to CH. Assists provider in completing applications to payers in a timely manner for billing and reimbursement to CH.
• Maintains current files of all provider information for the credentialing or re-credentialing process. Manages and maintains files of credentials in an effort to provide current documentation to third party payers to prevent uninterrupted cash flow to CH.
• Follows up with third party payers to facilitate insurance enrollment.
• Meets with newly hired or contracted providers in order to facilitate insurance enrollment process that billing office supports. Interacts with insurance representatives to facilitate and expedite the insurance enrollment process.
• Communicates enrollment process with providers, billing manager, and designated personnel of the organization.
• Assures insurance provider numbers are communicated to supervisors and managers for entry in IDX billing system.
• Completes timely follow-up of any CH provider enrollment issues based on spreadsheet timeline.
• Maintains departmental logs and spreadsheets for updating all insurance credentialing and re-credentialing.

MINIMUM REQUIREMENTS

• Education: High school diploma or equivalency.
• Experience: Previous credentialing knowledge while working in a physician office, hospital, or healthcare environment. Previous provider credentialing experience in a medical environment preferred. Medical billing experience preferred.
• Usual Work Day: 8 Hours

PHYSICAL DEMANDS AND WORK ENVIRONMENT

• Frequent physical demands include: Sitting , Standing , Walking , Keyboard use/repetitive motion
• Occasional physical demands include: Climbing (e.g., stairs or ladders) , Carry objects , Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Squat/kneel/crawl , Wrist position deviation , Pinching/fine motor activities
• Continuous physical demands include: Talk or Hear
• Lifting Floor to Waist 15 lbs. Lifting Waist Level and Above 10 lbs.
• Sensory Requirements include: Accurate Near Vision, Accurate Far Vision, Color Discrimination, Minimal Depth Perception, Minimal Hearing
• Anticipated Occupational Exposure Risks Include the following: N/A

IND123.

This position is eligible for the following benefits:

• Medical Plan

• Prescription drug coverage & In-House Employee Pharmacy

• Dental Plan

• Vision Plan

• Flexible Spending Account (FSA)

- Healthcare FSA

- Dependent Care FSA

• Retirement Savings and Investment Plan

• Basic Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance

• Supplemental Group Term Life & Accidental Death & Dismemberment Insurance

• Disability Benefits – Long Term Disability (LTD)

• Disability Benefits – Short Term Disability (STD)

• Employee Assistance Program

• Commuter Transit

• Commuter Parking

• Supplemental Life Insurance

- Voluntary Life Spouse

- Voluntary Life Employee

- Voluntary Life Child

• Voluntary Legal Services

• Voluntary Accident, Critical Illness and Hospital Indemnity Insurance

• Voluntary Identity Theft Insurance

• Voluntary Pet Insurance

• Paid Time-Off Program

The pay range listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining base salary and/or rate, several factors may be considered including, but not limited to location, years of relevant experience, education, credentials, negotiated contracts, budget, market data, and internal equity. Bonus and/or incentive eligibility are determined by role and level. 

The salary applies specifically to the position being advertised and does not include potential bonuses, incentive compensation, differential pay or other forms of compensation, compensation allowance, or benefits health or welfare. Actual total compensation may vary based on factors such as experience, skills, qualifications, and other relevant criteria.