NYU Langone Health is a fully integrated health system that consistently achieves the best patient outcomes through a rigorous focus on quality that has resulted in some of the lowest mortality rates in the nation. Vizient Inc. has ranked NYU Langone the No. 1 comprehensive academic medical center in the country for three years in a row, and U.S. News & World Report recently placed nine of its clinical specialties among the top five in the nation. NYU Langone offers a comprehensive range of medical services with one high standard of care across 6 inpatient locations, its Perlmutter Cancer Center, and over 320 outpatient locations in the New York area and Florida. With $14.2 billion in revenue this year, the system also includes two tuition-free medical schools, in Manhattan and on Long Island, and a vast research enterprise with over $1 billion in active awards from the National Institutes of Health.

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Position Summary:
We have an exciting opportunity to join our team as a Provider Enrollment Specialist.

In this role, the successful candidate under the direction of the Managers, Associate Direct and Director of Credentialing Operations, Clinical Affairs and Affiliates, the Provider Enrollment Specialist of Credentialing Operations is responsible for provider enrollment and related reporting activities.
The Specialist will ensure providers are credentialed and enrolled into contracted health plans in a timely with accurate information for members and billing. The Specialist will support processes including, but not limited to, intake, credentialing and re-credentialing, direct enrollment, delegation related activities, troubleshooting and resolving provider enrollment issues, as well as maintaining and monitoring of accurate credentialing database for all providers.
The Specialist is responsible for training the Credentialing team to improve accuracy of the credentialing database and other NYU provider systems; ensure timely and successful of provider enrollment, as well as timely responses and resolutions of FGP CRED inquiries/issues. The Specialist will provide feedback to management in processes and staff performance to improve the teams overall productivity and performance. The Specialist is responsible for preparing recommendations and reports to management, FGP administration and practice managers regarding provider enrollment processes and performances.

Job Responsibilities:

• Act as a liaison between NYU FGP Credentialing and payer plan representatives to ensure compliance with responsibilities as delegated entity, and timely and accurate provider data maintenance for plan surveys and payment.
• Manage the credentialing issue tracking mechanisms.
• Conduct audits on payer submission integrity to ensure business rules are enforced for plan websites.
• Establish and maintain working relationships with representatives from major payers
• Notify appropriate constituents when providers are departing the FGP and reconcile this information to ensure appropriate systems and reconciliations are reported.
• Interact with Central Billing Office, Professional Billing Information Systems and FGP administration to ensure credentialing system/billing system interface performance and appropriate claims production. 
• Maintain communication with practice administrators and/or business managers to assess any outstanding business needs. 
• Assist management in training staff in processes, providing initial and on-going guidance. Resolve and addresses procedure and performance related issues. 
• Monitor performance of FGP credentialing inbox, its staff and workflow.
• Ensure timely responses to internal customer population via the FGP Credentialing inbox.
• Must consistently maintain the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to the applicable federal, state and local laws and regulations, accreditation and licensure requirements.
• Provide support and insight for other workflows and special projects.
• Other duties and projects as assigned by the Managers and Director of Credentialing Operations.

Minimum Qualifications:
To qualify you must have a High School or GED. Three to five years of provider enrollment with Managed Care, Medicare/Medicaid. Excellent communication (both written and oral), detail orientation, customer service, organization, and multitasking skills. Intermediate computer skills, including Microsoft Office applications (Outlook, Word and Excel). Knowledge of Managed Care Credentialing.

Preferred Qualifications:
Bachelor's degree preferred with five (5) years experience working in credentialing, managed care, or healthcare management or equivalent.
Knowledge in managed care and governmental contracting/claims processes preferred.
Excellent computer and communication skills, knowledge of provider database a must.
Ability to analyze credentialing related data and prepare reports/dashboard data.
Excellent organizational skills; ability to prioritize and keep tasks moving forward.
Self-starter; high initiative; able to work both autonomously/independently and as a team member.
Exceptional skills in partnering with clients, managing vendors, and staff.

Qualified candidates must be able to effectively communicate with all levels of the organization.

NYU Langone Health provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents.

At NYU Langone Health, we are committed to supporting our workforce and their loved ones with a comprehensive benefits and wellness package. Our offerings provide a robust support system for any stage of life, whether it's developing your career, starting a family, or saving for retirement. The support employees receive goes beyond a standard benefit offering, where employees have access to financial security benefits, a generous time-off program and employee resources groups for peer support. Additionally, all employees have access to our holistic employee wellness program, which focuses on seven key areas of well-being: physical, mental, nutritional, sleep, social, financial, and preventive care. The benefits and wellness package is designed to allow you to focus on what truly matters. Join us and experience the extensive resources and services designed to enhance your overall quality of life for you and your family.

NYU Langone Health is an equal opportunity employer and committed to inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration. We require applications to be completed online.

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NYU Langone Health provides a salary range to comply with the New York state Law on Salary Transparency in Job Advertisements. The salary range for the role is $67,771.14 - $95,000.00 Annually. Actual salaries depend on a variety of factors, including experience, specialty, education, and hospital need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.

To view the Pay Transparency Notice, please click here