Under the direction of the Manager, Payer Enrollment and Delegation, the Enrollment Specialist is responsible for the enrollment of
Yale New Haven Health System practitioners with non commercial payers (Medicare, Medicaid, Tricare). This includes initiating the enrollment process from notification that a new practitioner has been added to the network and collaborating with Credentialing Specialists within Medical Staff Administration and the practitioner to complete the application process. This involves accurate and timely entry of provider data including contact information, status changes, and ensuring that verification of all required credentialing criteria has been completed in accordance with all policies and other applicable standards.
The position also includes responsibility for ensuring that the re-verification process and any interim or re-credentialing activities required by government payers occurs to ensure continuous, uninterrupted participation status for all practitioners.
This position maintains up to date and thorough knowledge of non-commercial payer enrollment obligations at the State and Federal level.
Minimum of 2-3 years experience in non commercial payer enrollment.
CPCS certification preferred but not required.
Internal Number: 2
About Yale New Haven Health
Yale-New Haven Health System is the largest health system in Connecticut, comprised of five (5) acute care hospitals with over 6,000 medical staff members. Yale New Haven, a 1,500 bed hospital is the anchor institution and primary affiliate of the Yale University School of Medicine.
Every employee understands and shares in the Yale New Haven Health System Vision, supports its Mission, and lives its Values. These values: integrity, patient-centered, respect, accountability, and compassion guide what we do, as individuals and professionals, every day.
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