Health Plan Enrollment Analyst

integratedresourcesinc
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📍 CA📍 San Francisco📍 San Francisco, CA, United States📍 usContract

About this role

Company Description

Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.

Job Description

This position is responsible for developing and overseeing the processes ensuring that all billing providers (approximately 2000) at Client and affiliates are appropriately and accurately credentialed and enrolled into all commercially contracted health plans, Medicare, Medi-Cal and Tricare which is required to appropriately generate revenue (approximately $500 million annually) in the course of patient care. This position ensures that each billing provider is qualified to provide health care services in accordance with Client policies and procedures, The Joint Commission and NCQA standards, commercial contracted agreements, as well as State and Federal laws and regulations including the Affordable Care Act.

This position works directly with leadership at both Medicare and DHCS to interpret changes in State and Federal regulations and the impact new regulations has on Client and develop new processes as necessary. This position works directly with Client billing agents and contracted health plans to resolve billing issues on a daily basis.

The incumbent does serve in a position of being more knowledgeable about the Federal, State and Managed Care regulations.

Qualifications

  • Bachelor’s degree or equivalent combination of education and experience; graduate degree can be substituted for experience.
  • Minimum of 8-10 years of work experience in healthcare environment with specific emphasis in provider enrollment, managed care, health plans affairs at an academic medical center and/or medical staff operations.

Additional Information

Feel free to forward my email to your friends/colleagues who might be available. We do offer referral bonus


Thank you for your time and consideration. I look forward to hearing from you!


Thanks & Regards,

Neha Pujari

Healthcare Recruiter

Integrated Resources, Inc.

IT Life Sciences Allied Healthcare CRO

Certified MBE |GSA - Schedule 66 I GSA - Schedule 621I

(Direct) 732-844-8736

Gold Seal JCAHO Certified ™ for Health Care Staffing

“INC 5000’s FASTEST GROWING, PRIVATELY HELD COMPANIES” (8th Year in a Row)

Frequently Asked Questions

Is the salary disclosed for the Health Plan Enrollment Analyst position at integratedresourcesinc?
The salary for this Health Plan Enrollment Analyst role at integratedresourcesinc is not publicly listed. Click "Apply Now" to learn more about the compensation package on their official careers page.
Where is the Health Plan Enrollment Analyst position at integratedresourcesinc located?
This Health Plan Enrollment Analyst role at integratedresourcesinc is based in CA, San Francisco, San Francisco, CA, United States, us. The position is listed as on-site or hybrid. Check the full job description or apply directly to confirm the work arrangement.
Is the Health Plan Enrollment Analyst role at integratedresourcesinc full-time or part-time?
This is listed as a Contract position. It is posted as a Health Plan Enrollment Analyst role at integratedresourcesinc.
How do I apply for the Health Plan Enrollment Analyst position at integratedresourcesinc?
Click the "Apply Now" button on this page. You will be redirected to integratedresourcesinc's official application portal hosted on smartrecruiters where you can submit your application directly.
When was the Health Plan Enrollment Analyst job at integratedresourcesinc posted?
This Health Plan Enrollment Analyst position at integratedresourcesinc was posted on Dec 6, 2016. Apply as soon as possible — early applications are often reviewed first.
Health Plan Enrollment Analyst
integratedresourcesinc
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You'll be redirected to integratedresourcesinc's official application page on SmartRecruiters.