"Alerted.org

At Logan Health, we're more than just a healthcare provider—we're a community. Nestled in the heart of Montana, we are committed to delivering exceptional care to our patients while fostering a supportive and collaborative work environment for our team. As a member of Logan Health, you'll be part of a dynamic team that values compassion, innovation, and excellence. We offer opportunities for growth, comprehensive benefits, and a chance to make a meaningful impact in the lives of those we serve. Come join us and experience the Logan Health difference, where your passion meets purpose in a place you’ll be proud to call home.

Are you ready to make a meaningful impact in healthcare by ensuring the seamless flow of payer enrollment and contracting processes? At Logan Health, we are seeking a meticulous and detail-oriented Payer Enrollment Contract Specialist to join our dynamic team. Your role will be pivotal in managing payer enrollment processes, ensuring compliance with regulations, and building strong partnerships that drive our mission forward.

Our Mission: Quality, compassionate care for all.

Our Vision: Reimagine health care through connection, service and innovation.

Our Core Values: Be Kind | Trust and Be Trusted | Work Together | Strive for Excellence.

Join Our Payer Enrollment Contract Specialist Team at Logan Health!

Key Responsibilities:

+ Manage Provider and Facility Enrollment: Take the lead in ensuring the timely and accurate submission of new provider, group, and facility enrollment applications across multiple insurance platforms. This includes revalidations, updates, and terminations for both commercial and government payers, ensuring all information remains current and compliant.

+ Maintain Provider Records: Ensure all provider credentials, licenses, certifications, and re-credentialing documents are up-to-date within internal systems and external databases. Proactively track expiration dates and renewals to avoid any lapses in coverage or credentialing.

+ Compliance & Regulatory Knowledge: Stay informed on evolving healthcare regulations, payer policies, and enrollment standards. Ensure that all processes adhere to federal, state, and payer-specific guidelines, including HIPAA and Medicare requirements.

+ Liaison with Stakeholders: Serve as the main point of contact for providers, internal departments, and insurance payers. Facilitate smooth communication between all parties to resolve enrollment issues efficiently and maintain seamless payer relationships.

+ Provider Support & Issue Resolution: Respond promptly to inquiries from providers and internal managers regarding enrollment matters. Troubleshoot issues related to enrollment, billing, and payer credentialing to ensure continuous and uninterrupted coverage for providers.

+ Database & System Management: Ensure accurate and timely data entry of all provider-related information into payer systems and internal databases. Regularly audit these systems to ensure compliance and resolve discrepancies swiftly.

+ Enhance Enrollment Processes: Continuously seek ways to improve payer enrollment workflows. Collaborate with cross-functional teams to identify areas for optimization and implement strategies that streamline processes and reduce administrative bottlenecks.

Basic Qualifications:

+ 3+ years of experience in an administrative role.

+ Proficiency in Microsoft Office Suite, with intermediate knowledge of Microsoft Excel, including data entry, formulas, and basic functions.

Preferred Qualifications:

+ Experience working with Commercial and Government Payers to ensure proper claims processing and reimbursement.

+ Experience working with high-level and senior leadership, demonstrating a strong ability to manage sensitive situations with professionalism.

+ A background in healthcare or customer service with an understanding of medical terminology.

+ Strong attention to detail and the ability to prioritize tasks in a fast-paced environment.

+ Excellent communication and interpersonal skills to collaborate effectively with diverse teams and stakeholders.

+ Ability to handle sensitive and confidential information with professionalism and diplomacy.

+ Demonstrated problem-solving skills and the ability to think critically and independently in complex scenarios.

---

Qualifications:

+ Minimum of three (3) years administrative experience required. Experience working with complex administrative support tasks preferred.

+ Proficient with Microsoft Office Suite and possess ability to learn other software as needed required.

+ Possess knowledge and understanding of data entry and retrieval skills preferred.

+ Demonstrated ability to work with complex documents and possess knowledge of commonly-used concepts, practices and producers for contract management.

+ Excellent organizational skills, detail-oriented, a self-starter, possess critical thinking skills and be able to set priorities and function as part of a team as well as independently.

+ Commitment to working in a team environment and maintaining confidentiality as needed.

+ Excellent verbal and written communication skills including the ability to communicate effectively with various audiences.

+ Excellent interpersonal skills with the ability to manage sensitive and confidential situations with tact, professionalism, and diplomacy.

Job Specific Duties:

+ Assists in the day to day tasks to include, but may not be limited to; document preparation, amendments, report preparation, special projects, etc.

+ Assists in the management of leases, contracts, and associated documentation including, but not limited to; entry of documents and all relevant information into the designated database, interacts with appropriate personnel for document review related to renewal, amendment, etc.

+ Assists in the development and administration of instructions and guidelines for document management.

+ Assists in the review of submitted documents for completeness, execution and retrieves additional information to ensure completeness. Provides assistance with lease, contract and/or property database management for Administration.

+ Assists with the entry of leases, property purchase documents, and property closing files into the designated database. Interacts with appropriate personnel for contract review related to renewal, amendment and/or other aspects of property management.

+ Assists with the preparation and uploading of documents for the IRO annual audit.

+ Assists in the oversight and maintains the Arrangement Covered Persons and users in Compliance 360.

+ Interacts and communicates professionally with facility owner, tenants and vendors with regard to property related interactions.

+ Provides coverage to all areas of department as needed and assists with projects as assigned. Duties may pertain to all or specific department functional areas:

+ Supports contract processes which include, but may not be limited to; assists with audits of the contract tracking system, ensures contract go through the proper process per LH policy, assists in the property management function for principally non-hospital facilities.

+ Supports compliance processes which include, but may not be limited to; assists in obtaining, maintaining and tracking payer certifications for providers and/or facilities, ensures contracted providers are credentialed and enrolled with third party payers, responsible for re-credentialing activities required by payers

The above essential functions are representative of major duties of positions in this job classification. Specific duties and responsibilities may vary based upon departmental needs. Other duties may be assigned similar to the above consistent with knowledge, skills and abilities required for the job. Not all of the duties may be assigned to a position.

Maintains regular and consistent attendance as scheduled by department leadership.

Shift:

Day Shift - 8 Hours (United States of America)

We are committed to creating a supportive, team-driven environment where your skills can flourish. Our organization operates 24/7, offering flexibility in your schedule while empowering you to be a part of something bigger—improving healthcare outcomes for all.

Schedules are set to accommodate the requirements of the position and the needs of the organization and may be adjusted as needed.

Notice of Pre-Employment Screening Requirements

If you receive a job offer, please note all offers are contingent upon passing a pre-employment screening, which includes:

+ Criminal background check

+ Reference checks

+ Drug Screening

+ Health and Immunizations Screening

+ Physical Demand Review/Screening

Equal Opportunity Employer

Logan Health is an Equal Opportunity Employer (EOE/AA/M-F/Vet/Disability). We encourage all qualified individuals to apply for employment. We do not discriminate against any applicant or employee based on protected veteran status, race, color, gender, sexual orientation, religion, national origin, age, disability or any other basis protected by applicable law. If you require accommodation to complete the application, testing or interview process, please notify Human Resources.