- Initiates the payer enrollment process with all payers identified by client for enrollment
- Completes all required applications for submission to payers
- Coordinates credentialing data needed for enrollment, contracting, and other related purposes
- Creates providers in CAQH ProView as necessary
- Enters and updates clinician information in the database
- Collects, monitors, and analyzes enrollment operations performance data relative to established goals and metrics to identify potential risks and/or areas of opportunity and prepares action plans for improvement
- Focuses on enrollment related continuous process improvement to ensure optimal operation
- Acts as liaison to CVO, clients, outside agencies, physicians, medical practice groups, health plans, etc.
- Responds to internal and external inquiries on routine enrollment and contract matters
- Works closely with clinicians to obtain missing documentation pertaining to provider enrollment
- May work on special projects or other duties as assigned
- May communicate with clinicians, clients, and insurance providers
- High School Diploma or equivalent required. Bachelor's Degree preferred.
- 3+ years of related experience required
- Ability to adhere to and exhibit the Company Values at all times
- Working knowledge of Microsoft Word, Excel, PowerPoint, Outlook, and Teams
- Working knowledge of CMS, PECOS, CAQH, NPPES payer credentialing software
- Working knowledge of PDF editing software
- Working knowledge of Salesforce
- Ability to build relationships at all levels - internally and externally
- Strong customer service mindset
- Strong organizational and time management skills
- Ability to work independently
- Strong communication skills - both oral and written
- Ability to work with sensitive information and maintain confidentiality
- Solid critical thinking and problem-solving skills
- Strong attention to detail and accuracy
- Business Insight
- Interpersonal Savvy
- Customer Focus
- Communicates Effectively
- Balances Stakeholders
- Organizational Savvy
- Action Oriented
- Instills Trust
- Resourcefulness
- Situational Adaptability
- Collaborates
- Typical office environment - sedentary with typing, writing, reading requirements
- May be able to sit or stand
- Speaking, reading, writing, ability to use a telephone and computer
- Ability to exert up to 10 lbs. of force occasionally
- Ability to interpret various instructions
- Ability to deal with a variety of variables under only limited standardization
- Company-paid benefits (Basic Life and AD&D, Short and Long-Term Disability, Employee Assistance Program, Compass Health Advocate and Transitions).
- Healthcare benefit options (Value Plan, High Deductible Plan with HSA, Healthcare FSA, Dependent Care FSA, Prepaid Legal Services, 529 Savings Plan, Pet Insurance).
- Paid maternity and paternity leave.
- 401K with 35% match for every dollar up to 8%.
- PTO that accrues at a rate of 15 days/year for 1st year and continues to increase with tenure.
- Tuition reimbursement for continuing education.
- An opportunity to work at a state-of-the-art facility in Alpharetta which features an on-site daycare and cafeteria, world-class fitness center and wellness clinic.
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Provider Enrollment Specialist - Alpharetta, United States - LocumTenens
Description
Overview
Check out our current job openings and apply today
This is the beginning role to a long-term career with our company.
has been leading the way in a booming healthcare industry since 1995. Locum Tenens is a Latin phrase meaning, "to substitute for." When hospitals are understaffed, they rely on us to find them the right temporary physicians to fill in when needed. Every associate at plays a role in getting patients seen, no matter what they studied in school or what their role is here. Located in Alpharetta, GA, we boast a state-of-the-art campus featuring world-class amenities. There's nothing ordinary about a typical day here, take a look for yourself: .
We are a Jackson Healthcare company and we are now the second largest healthcare staffing company in the U.S., serving more than 7 million patients in over 1,400 healthcare facilities.
The Provider Enrollment Specialist facilitates the physician and mid-level enrollment applications process for Medicare, Medicaid, and commercial payers. This role is responsible for preparing and submitting supporting documentation for the purpose of enrolling individual physicians and mid-levels. This position is also responsible for follow up on the status of applications and tracking the progress on all pending applications.
Prepares Enrollment Documentation and Applications - 80%
Internal and External Liaison - 20%
SECONDARY FUNCTIONS (IF APPLICABLE)
SUPERVISORY/BUDGETARY/EXTERNAL COMMUNICATION RESPONSIBILITY
QUALIFICATIONS - EDUCATION, WORK EXPERIENCE, CERTIFICATIONS
KNOWLEDGE, SKILLS, AND ABILITIES
KEY COMPETENCIES REQUIRED
PHYSICAL, MENTAL, WORKING CONDITION, AND TRAVEL REQUIREMENTS
What is in it for you
EEO Statement
Locum Tenens is an EEO/AA Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender, gender identity and expression, national origin, age, disability or protected veteran status. We celebrate diversity and are committed to creating an inclusive environment for all of our associates.
