This job has closed.

BestSelf Behavioral Health · 1 month ago

Provider Enrollment & HR Analyst

Buffalo, NY

Full-time

Onsite

Mid Level

$24.50/hr - $28.57/hr

4+ years exp

BestSelf Behavioral Health is an organization focused on providing behavioral health services. The Provider Enrollment & HR Analyst is responsible for managing applications for enrolling physicians with payers and performing HR-related administrative tasks to support the agency's human resource management.

CommunitiesHealth CareHome Health CareNon Profit

Responsibilities

Maintain updated knowledge of Provider Enrollment regulations and develop new/update existing procedure documentation

Collaborate with insurance carriers to ensure the team is enrolling new BestSelf programs by following the applicable requirements and enrollment procedures

Investigate new external electronic platforms used by insurance carriers and ensure the team is prepared to utilize efficiently and effectively

Receive and analyze all verified documentation for Providers and execute provider enrollment with carriers

Process new enrollments, revalidations, and making sure all providers are linked with their appropriate sites

Shares essential updates with providers and internal teams as necessary in weekly summary reports or other correspondence

Collaborate with the Billing team on enrollment issues to investigate and correct

Work closely and effectively with the Insurance Carriers and Providers

Correspond with providers and Program Directors as necessary

Establish a relationship with the carrier credentialing representative and keep up on any changes or updates with the carriers

Communicate with providers on any enrollment issues, needs and updates

Update Providers CAQH accounts

Runs various audit reports on a determined frequency from the HRMS to ensure employee data and file documentation is compliant

Provide reports to HR management team, SMT and/or EMT as requested by the Talent Acquisition and HRIS Manager

Protects employee data by maintaining access rights to our employee databases and documents

Assists the Talent Acquisition & HRIS Manager in confidential tasks associated with Human Resource management of the agency

Enters, updates, and verifies data in HRMS as directed

Works closely with the other branches within the agency to provide a seamless employee experience as it relates to their career, wages, and benefits

Serve as a liaison between the agency and our HR systems in developing new processes and resolving any technology issues that may arise

Using state and national web sites, monitors license and other sanctions monthly

Develops and maintains mechanisms to track agency wide audit information, such as excel spread sheets and HR software

Promote agency's Racial Equity and Inclusion concepts

Builds and maintains an effective, professional, and positive working relationship with all levels of employees

Provides timely, caring, and thorough employee service when employee inquiries are received

Provide support and guidance to the HRIS and Talent Acquisition teams as needed and as requested

Maintain confidentially and containment with to remain in compliance with HIPAA and protect employee information at all times

Completes all trainings required by the agency

Performs all other duties as assigned

Qualification

Provider Enrollment cycleReport writing databasesInsurance carriers processesMicrosoft Office SuiteNCQA standardsUnderstanding agency programsConfidentialityCommunication skillsTime managementAttention to detail

Required

Bachelor's degree in Business or Human Resources and 2 years of HR related experience - OR- Associate's degree in Business or Human Resources and 4 years of HR related experience

2 years of experience with processing the full Provider Enrollment cycle

Strong knowledge working with report writing databases as well as common office technology/software including the use of the Microsoft Office Suite

Ability to maintain confidentiality

Excellent communication skills with all levels of staff

Efficient time management

High attention to detail

Understanding of the agency's programs and services

Experience working with and full understanding of insurance carriers' processes

Familiarity with NCQA standards and how to apply them

Proficient with basic computer systems, networks, and software applications, such as the Microsoft Office Suite (Outlook, Word, and Excel)