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Description & Requirements
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
What's In It For You
At St. Luke’s, caring for people in the communities we serve is our mission – and this includes our own SLHS team. We offer a robust benefits package to support our teams both professionally and personally. In addition to a competitive salary and retirement plans, we ensure our team feels supported in their benefits beyond the typical medical, dental, and vision offerings. We care about you and have fantastic financial and physical wellness options, such as: on-site massages, on-site counseling via our Employee Assistance Program, access to the Personify Health Wellness tool, as well as other formal training and career development offerings to ensure you are meeting your career goals.
St. Luke’s is an equal opportunity employer and does not discriminate against any person on the basis of race, religion, color, gender, gender identity, sexual orientation, age, national origin, disability, veteran status, or any other status or condition protected by law.
*Please note: this posting is not reflective of all job duties and responsibilities and is intended to provide an overview to job seekers.