Sanford Health Provider Enrollment Representative - Provider Enrollment in Bemidji, Minnesota

Job Title: Provider Enrollment Representative | Provider Enrollment | Fargo or Sioux Falls

City: Fargo

State: Multi-State

Department : Provider Enrollment

Job Schedule: Full Time

Shift: Days

Hours Per Shift: 8 hr

JOB SUMMARY

Primary function is to enroll new providers with payors as well as new facility sites. Re-enroll existing providers and facility sites with payors. Obtain provider number(s)/effective dates for billing purposes. Apply for individual practitioner and/or facility national provider identifier (NPI) via national plan and provider enumeration system (NPPES). Maintain practitioner and facility files with accurate and up-to-date data. Notify payors and internal contacts of practitioner practice changes, including terminations, cases of malpractice, or other legal matters. Respond to research issues received thru internal or external contacts. Review charges/claims pending report. Enrollment for electronic claims submission. Updating and maintaining provider numbers and related data in both internal and external billing software and production programs. Maintain supporting documentation such as a W-9, CLIA certificate, bank, IRS, and CMS letters as applicable. Attend site planning meetings to provide input, gather necessary information for set up, and provide updates. Notify payors of site notification for payors (i.e., for new sites, site terminations, and changes).

QUALIFICATIONS

Associate's Degree in Business, Healthcare Administration or a related field required. Prior work experience in a healthcare field is preferred including prior insurance billing, provider enrollment or credentialing. Must be able to manage complex multiple tasks, work autonomously, and make critical decisions. Must be proficient in organizational, written and oral communication skills, and have the ability to access, manipulate, organize and relay information in meaningful ways using email, word processing, spreadsheets, and data-base management.

About Sanford Health:

At Sanford Health, we are dedicated to the work of health and healing. Every day, we show that commitment by delivering the highest quality of care to the communities we serve. We are leaders in health care and strive to provide patients across the region with convenient access to expert medical care, leading-edge technologies and world-class facilities.

In addition to strong clinical care, we are also committed to research, education and community growth. We engage in medical research to not only discover innovative ways to provide care, but also cures for common diseases. We continuously seek new ways to achieve our vision of improving the human condition here in your community, across the region and around the world.

The entire team at Sanford Health recognizes the value of healthy families and communities. We continue to gain momentum and expand our reach. Together, we can make a positive difference now, and in the future.

Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-243-1372 or send an email to talent@sanfordhealth.org .

In compliance with federal law requiring employers to verify new employees' U.S. employment eligibility, Sanford participates in E-Verify. To learn more click here for English Version at https://e-verify.uscis.gov/emp/media/resourcesContents/EverifyPosterEnglish.pdf or here for Spanish Version at https://e-verify.uscis.gov/emp/media/resourcesContents/EverifyPosterSpanish.pdf .

City: Multi-City

State: Multi-State

Job Function: Revenue Cycle

Job Schedule: Full Time

Shift: Days

Req Number: req10498