REMOTE POSSIBLE FOR THE FOLLOWING APPROVED STATES:

Approved Remote States:

1. Arizona

2. Florida

3. Georgia

4. Idaho

5. Indiana

6. Iowa

7. Maine

8. Michigan

9. South Dakota

10. Texas

11. South Carolina

12. North Dakota

13. Wisconsin

14. Tennessee

Position Summary:

The Revenue Cycle Enrollment Specialist coordinates, completes and monitors the provider/facility payer credentialing process. Processes credentialing and re-credentialing applications for health care providers. sends, reviews, and verifies credentialing applications. Loads and maintains provider information in an online credentialing database system. Tracks license and certification expirations for medical staff to ensure timely renewals. Handles and resolves inquiries regarding credentialing information, process, or status.

Minimum Qualifications:

• Associate’s degree; equivalent combination of education and experience will be considered

• Current Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Staff Management (CPMSM) by the National Association of Medical Staff Services (NAMSS) or obtained within two (2) years of hire

• Two (2) years of healthcare experience

• Preferred: One (1) year of payer credentialing experience

Essential Job Functions:

• Collect, review, and prepare data for final medical staff and allied health professionals “Providers” credentials review for the clinic, hospital, and payer environments and Bozeman Health “Facility” payer enrollments. Work with Providers and department leaders to obtain any missing information. Process requests for additions or changes in payer enrollment

• Ensure that requisite licenses, malpractice coverage, and certifications are current for all Providers and Facilities

• Perform delegated credentialing for all applicable payers and supplies applicable payers with timely provider rosters.

• Maintain files on Providers and Facilities, including information related to licensure or clinical practice disciplinary actions, clinical practice restrictions, and medical malpractice suits, judgments, and settlements.

• Provide requested reports as directed.

• Maintain current knowledge of and compliance with medical staff accreditation standards with applicable regulatory agencies and licensing standards. Participate in the development and implementation of credentialing policies and procedures.

• Manage payer response to re-validation for Provider and Facility enrollments to avoid any lapse in enrollment

• Provides concise, timely communication to appropriate leadership regarding potential credentialing issues

Knowledge, Skills and Abilities

• Demonstrates sound judgment, patience, and maintains a professional demeanor at all times

• Exercises tact, discretion, sensitivity, and maintains confidentiality

• Performs essential job functions successfully in a busy and stressful environment

• Learns current and new computer applications and office equipment utilized at Bozeman Health

• Strong interpersonal, verbal, and written communication skills

• Analyzes, organizes, and prioritizes work while meeting multiple deadlines

• Works varied shifts as scheduled and/or needed

Physical Requirements

• Lifting, Pushing, and Pulling: Lift 30 pounds of weight (pick up supplies, move equipment, etc.) Carry equipment/supplies.

• Extended Hours: The role may involve working for extended periods, requiring sitting, walking, or standing for eight or more hours daily.

• Flexible Schedule: The position may necessitate working beyond a standard 40-hour workweek, including weekends and after-hours shifts

• On-Call Availability: On-call work may be required to respond promptly to organizational, patient, or employee needs

• Effective Communication: Proficient in effective communication, both in person and through various technologies

• Handling Challenging Situations: The role may involve dealing with upset individuals, requiring the ability to de-escalate situations and work effectively with frustrated patients, families, or employees

• Repetitive Tasks: Ability to perform repetitive tasks as needed to fulfill job responsibilities

Exposures

Tasks Include Potential Exposure: Job tasks may involve exposure to:

• Bloodborne pathogens, such as blood, bodily fluids, or tissues.

• Radiation in settings where medical imaging procedures are performed

• Various chemicals and medications used in healthcare settings. Job tasks may involve handling cleaning products, disinfectants, and other substances.

• Infectious diseases due to contact with patients in areas that may have contagious illnesses

The above statements are intended to describe the general nature and level of work being performed by people assigned to the job classification. They are not to be construed as a contract of any type nor an exhaustive list of all job duties performed by individuals so classified.

77211370 Patient Financial Services

Working at Bozeman Health is more than just a job--it's a commitment to caring for the communities of Southwest Montana by being their partner in health and wellness, compassionately delivering the best care for each person, every time. In every role, our employees are inspired by their ability to care for our community and our Culture of Excellence guides each employee to be a high performer, engage in transparent and timely communication, demonstrate dynamic learning and teaching, excel through change, express gratitude and experience joy.