Analyst - Enrollment & Credentialing
at Adventist Health System

Date Posted: 5/21/2017

Job Description

Job:  Other Non-Clinical Professional

Organization:  Adventist Health System Corporate Office

Shift:  Day

Job Posting:  Mar 20, 2017, 4:20:41 PM

If you want to be a part of a place that provides nothing less than extraordinary compassionate care, then Adventist Health System is the place for you!

We are currently seeking qualified candidates for a Reimbursement Analyst position that will be based in our Managed Care department.  This position is based in Altamonte Springs, FL.

The Provider Enrollment & Credentialing Analyst applies technical, analytical, and problem-solving skills to provide solutions/improvements within the department.  Responsible for completing financial and/or operational analysis of provider payer enrollment and credentialing data, developing and tracking key performance indicators, comparative analysis and bench marking. This person demonstrates competences in decision support and reporting through converting raw data into useful and actionable information.  This person is responsible for compiling and analyzing data as well as for creating meaningful applications to support executive decision making, including monthly summary reporting and special projects as assigned. Character traits include: strong work ethic, trainability, communicative, team player all with a positive “can do” attitude. Intermediate Excel skills required. 

Specific job duties include:

Provider Enrollment & Credentialing-25%

  • Supports Managed Care leadership in report creation, validation, analytical interpretation and distribution; supports decision making.
  • Facilitates the credentialing process; collects and communicates new additions, terminations, and demographic changes to delegated payers.
  • Conducts payer provider roster audits, and payer payment and timeliness audits.
  • Identifies needs and serves as liaison with governmental and commercial provider enrollment teams and payers regarding provider number approvals and effective dates for AHS providers and affiliates.
  • Utilizes a variety of software applications and data sources to produce standard enterprise reporting on providers and creates ad-hoc reports as requested.
  • Supports Credentialing & Revenue Management Director and Team in timely and efficiently completing financial analyses related to Managed Care provider enrollment and credentialing.
  • Completes multiple projects in a fast-paced environment within timeframes outlined in the department policies and as specified by Leadership
  • Adapts to new situations and changing priorities to accomplish project deadlines and department goals
  • Demonstrates strong project management and organizational skills by maintaining up-to-date project lists to assist in setting appropriate project priorities
  • Applies technical expertise in the development of analytics and decision support information
  • Assures the application of appropriate standards of data analysis and that all analytics are quality checked
  • Develop an understanding of provider enrollment and credentialing and their impact on internal systems and other departments
  • Fully documents the process required to replicate any analytic process undertaken
  • Contributes to the overall completion of the work product in group project situations
  • Maintains and utilizes available resources to ensure work is completed accurately and timely
  • Displays a willingness to grow and develop skills required to perform his/her job duties
  • Takes the initiative to seek out education and training to stay informed of changes in the field of managed care
  • Participates in meetings as assigned or requested
  • Communicates problems and recommends solutions to Director of Credentialing and Revenue Management
  • Adheres to applicable internal policies, procedures, and guidelines as set forth by Adventist Health Systems, its associated hospitals, physician groups, PHOs and ancillaries during the execution of assigned duties
  • Abides by all applicable rules, regulations, and laws prescribed by any authoritative governing body such as the State of Florida, AHCA, etc.
  • Does not interfere with the ability of co-workers to complete their duties

Job Requirements

Education Requirements:
  • Bachelor’s Degree in business, healthcare administration or related field
Experience Requirements:
  • Minimum 3 experience in financial reporting.

If this position sounds like a great match for your skills set and experience, please apply online now!

Job Snapshot

About Us

About Adventist Health System

Who We Are

We are one of the largest faith-based health care providers in the United States. For 150 years, we have carried on a tradition of providing whole-person care that not only addresses patients' physical ailments, but also supports their emotional and spiritual well-being. We demonstrate the same level of compassion and care for our employees as well, doing all that we can to help them realize their full potential – both personally and professionally.

Who You Are

You are a compassionate, talented professional who wants to work in an environment where you can live out your faith and your values. You are excited about being part of a team that uses the latest technology and medical research to ensure patients receive quality care, but who also recognize that great care is always personal. You enjoy going out of your way to make each patient and their family feel special, and are passionate about guiding them toward optimal health.

Our Community

Our community is global and so is our reach. From coordinating medical mission trips in Ethiopia to planting school gardens in Florida, we are constantly seeking ways to go beyond hospital walls in improving the health of our communities. As a member of our team, you will be encouraged to use your talents in fun, meaningful ways that bring joy and healing to people around the world.

Our Mission

Part of this worldwide network, Adventist Health System was founded in 1973 to support and strengthen the Seventh-day Adventist health care organizations in the Southern and Southwestern regions of the United States. Today it is a national leader in quality, safety and patient satisfaction, comprised of 46 hospital campuses and nearly 77,000 employees.

Although separated by geography, each of our facilities is united by the mission of Extending the Healing Ministry of Christ. Today we continue the tradition of whole-person care by practicing and sharing CREATION Health, a blueprint for living a healthy, happy life based on the principles given in the Bible’s creation story: Choice, Rest, Environment, Activity, Trust, Interpersonal relationships, Outlook and Nutrition.

We provide comprehensive benefits, training and advancement opportunities. We care for our employees as well as we care for our patients.