Consultant, Payor Enrollment
- Full-time
- Shift: Day Shift
- Status: PRN
Company Description
More Than Just Care, It’s Community
Imagine doing meaningful work in a place where people vacation. That’s life at Munson Healthcare - northern Michigan’s largest healthcare system, with eight award-winning community hospitals serving over half a million residents across 29 counties.
If you want a career in healthcare and a lifestyle most people only dream about – with freshwater lakes, scenic trails, charming downtowns, a vibrant arts scene, and endless outdoor adventures - you might just be Munson Material. To us, that means teammates who live by our values of excellence, teamness, positivity, creativity, and a commitment to creating exceptional experiences for our patients and each other. Join a team that delivers outstanding care in one of the most beautiful regions in the country.
Job Description
- Lead and coordinate all payor enrollment activities, ensuring timely submissions, approvals, and maintenance of active provider enrollments.
- Serve as the primary escalation point for complex enrollment and credentialing issues, partnering with health plans to resolve challenges and implement solutions.
- Monitor enrollment operations, including status updates, team inquiries, audits, KPI reporting, and final review of payer submissions.
- Collaborate with credentialing, onboarding, revenue cycle, and operational teams to support provider onboarding, enrollment compliance, and resolution of enrollment-related denials and underpayments
Qualifications
- Bachelor’s degree required.
- Minimum of five (5) years of experience in physician services, revenue cycle, or another healthcare-related field required.
- Three (3) years of management or leadership experience preferred.
- Knowledge of payor requirements required; knowledge of NCQA credentialing standards and the ability to interpret data within computerized information systems preferred.
Additional Information
Are you Munson Material? Apply today!
Munson Healthcare requires all employees be vaccinated or have lab confirmed immunity for Measles, Mumps, Rubella and Varicella. MHC also requires all employees to receive a flu vaccine during the flu season in the year that they are hired and annually thereafter, or receive an approved medical or religious exemption.
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