Provider Enrollment Project Analyst

Sanford Health

3d•$23 - $36

About The Position

The Provider Enrollment Project Analyst is responsible for ensuring the timely enrollment of new providers and new facility sites with payors. Works directly with leadership on special projects, supporting planning, communication, and staffing resources. Assists Representative staff in identifying and updating the required supporting documentation. Serves as the primary contact for Clinical Leadership and participates in New Service Line (NSL) meetings to ensure resulting assignments are accurate and updated as needed. This position works closely with the Supervisor to support project management across the various Provider Enrollment teams. Attend New Service Line (NSL) meetings to ensure assignments are accurately reflected and updated in a timely manner. Communicates with Clinical leadership regarding project timelines and coordinates adjustments to effective dates as needed based on resource availability. Supports Representatives in maintaining and collecting required documentation. Monitors and oversees the process to gather current, accurate, and complete information for provider directories. Serves as a data integrity champion within the Credential Stream system to ensure timely and accurate reporting. Collaborates with the leadership team to identify workflow improvement opportunities within the Provider Enrollment processes and recommends strategies to enhance efficiency. Assists with internal and external research inquiries and supports staff working in work queues (WQs) to ensure all necessary enrollment assignments are addressed. May perform follow-up work within Epic work queues to resolve enrollment-related issues. Stays current on changes in managed care and other payor requirements related to provider enrollment. Completes work within the required timeframes to ensure compliance with departmental standards, regulatory requirements, and payor deadlines. Participate in site-planning meetings to provide input, gather necessary information for setup, and share updates as needed. Performs other duties as assigned.

Requirements

Associate degree required.
Minimum of 4 years experience providing customer service, as well as entering data into provider enrollment, or EMR systems or project management required.
High level of knowledge and computer skills, including the ability to use the range of Microsoft products.

Nice To Haves

Bachelor’s degree preferred.
In lieu of degree, leadership may consider three years of equivalent work experience.
Previous experience specifically working as billing representative, credential specialist, or provider enrollment preferred.

Responsibilities

Ensuring the timely enrollment of new providers and new facility sites with payors.
Working directly with leadership on special projects, supporting planning, communication, and staffing resources.
Assisting Representative staff in identifying and updating the required supporting documentation.
Serving as the primary contact for Clinical Leadership and participates in New Service Line (NSL) meetings to ensure resulting assignments are accurate and updated as needed.
Supporting project management across the various Provider Enrollment teams.
Attending New Service Line (NSL) meetings to ensure assignments are accurately reflected and updated in a timely manner.
Communicating with Clinical leadership regarding project timelines and coordinates adjustments to effective dates as needed based on resource availability.
Supporting Representatives in maintaining and collecting required documentation.
Monitoring and overseeing the process to gather current, accurate, and complete information for provider directories.
Serving as a data integrity champion within the Credential Stream system to ensure timely and accurate reporting.
Collaborating with the leadership team to identify workflow improvement opportunities within the Provider Enrollment processes and recommends strategies to enhance efficiency.
Assisting with internal and external research inquiries and supports staff working in work queues (WQs) to ensure all necessary enrollment assignments are addressed.
Performing follow-up work within Epic work queues to resolve enrollment-related issues.
Staying current on changes in managed care and other payor requirements related to provider enrollment.
Completing work within the required timeframes to ensure compliance with departmental standards, regulatory requirements, and payor deadlines.
Participating in site-planning meetings to provide input, gather necessary information for setup, and share updates as needed.
Performing other duties as assigned.