Wind River Cares, click for home. Wind River Cares, click for home.

Arapahoe
(307) 856-9281

Ethete Clinic
(307) 855-2992

Riverton Clinic
(307)240-5234




DEPARTMENT: Business Office
REPORTS TO: Business Office Manager
SALARY: D.O.E
JOB TYPE: Permanent/Full-Time/Non-Exempt
OPEN DATE: February 16, 2022
CLOSE DATE: Until filled


JOB OVERVIEW:

This position completes and processes payer enrollment application for healthcare providers and allied health practitioners for Medicaid, Medicare, BCBS, Tricare, commercial, and other identified plans in the market. Also aids with the collections of delinquent accounts.


DUTIES AND RESPONSIBILITIES:

Facilitates enrollment of all new WRFCHC healthcare providers and allied health practitioners.
Responsible for establishing standard work in entering, updating, and ensuring practitioner information is current and accurate in both the internal software and with external payers.
Works closely with credentialing in obtaining copies of National Provider Identifier (NPI) numbers, licensure, certificates, and other documents necessary for the enrollment process.
Process enrollment applications for healthcare providers and allied health practitioners for Medicaid, Medicare, BCBS, Tricare/CHAMPUS, commercial, and other identified plans in the market.
Conducts verification of all data, ensuring accuracy and timely entry of information based on health plan deadlines and revalidation expirations numbers.
Adheres to deadlines and enrollment schedules by tracking files through all stages.
Assists with problem identification and timely resolution of payor related issues surrounding claim submission and denial management to ensure optimal reimbursement.
Performs tracking and follow-up to ensure providers are linked to appropriate health plans in a timely manner and communicated to release pending claims.
Consistently communicates essential updates with providers, payers, medical staff office, billing office via email, phone, and mail through reporting methods.
Maintains confidentiality and responsibility for all enrollment files through the process.
Research, correct, and resubmit rejected, denied, and returned claims timely.
Monitors all assigned payers and update status weekly with supervisor.
Other duties as assigned to maintain and enhance the operation of the program.


QUALIFICATIONS:

High school diploma or GED.
Associates degree in Accounting, Public Administration, or related field.


MINIMUM QUALIFICATIONS

Two (2) years of working experience with provider enrollment and EMR systems, collection of co-pays, and insurance verification for different insurance plans.
Excellent organizational skills and attention to detail with high degree of accuracy.
Demonstrate strong interpersonal skills and excellent written and verbal communication skills.
Must have the ability to use Microsoft word, excel and various electronic medical systems.
Must be able to multi-task and adhere to strict deadlines in a fast-paced office environment.
Current BLS Certification or must be able to obtain it within 60 days of hire.


IMPORTANT APPLICATION CRITERIA:

Submit a complete application with supporting documents to WRFCHC Human Resource Department located at 120 North 6th East St (Old DFS Bldg.), Riverton WY.

Fillable online application and download applications are also available at windriver.care and can be emailed to This email address is being protected from spambots. You need JavaScript enabled to view it..

For any questions, please contact Susan Apodaca 307-851-5100.

Supporting documents: Proof of Covid Vaccination and Booster, Driver’s License, Tribal ID, High School Diploma/GED, Degree or professional credentials, and other supporting documents that verify required qualifications.

Applicants who have a current application on file, please submit a letter of interest for each position in which you want to be considered for. The letter should address how you meet each qualification. Telephone calls are not accepted in place of an employment application or letter of interest.

Background investigation, drug and alcohol screening are required as a condition of employment. Refusal will render the applicant ineligible for employment.