Provider Enrollment Specialist - Alpharetta, United States - Jackson Healthcare

Jackson Healthcare Alpharetta, United States

2 weeks ago

Description

Overview

For over 22 years, Premier Anesthesia has been a highly trusted anesthesia practice management partner for healthcare organizations nationwide. With a wealth of knowledge and skill in hospital-based anesthesia practices, they focus on developing and managing anesthesia services tailored to the needs of their clients, medical staff and communities. From recruitment to efficient management, Premier Anesthesia is dedicated to ensuring optimal patient and client outcomes.

Premier Anesthesia is a national anesthesia management company solely focused on building and managing the best anesthesia teams in the industry. The organization's leadership brings extensive experience in hospital-based physician staffing, recruiting and management. Premier Anesthesia is part of the award-winning Jackson Healthcare family of companies.
The Provider Enrollment Coordinator is responsible for preparing and submitting credentialing applications and supporting documentation for the purpose of enrolling individual clinicians and provider groups with payers. In this role, you will ensure the setup of the clients for electronic claims submission and electronic remittance advice. You will follow up on the status of applications for clinicians and payers and track the progress on all pending applications. The primary responsibility will be to collect and manage all credentialing documents for our providers, submit enrollment applications to insurance companies and track their progress. Coordinate on boarding documents with recruiting and hospital credentialing.
ESSENTIAL FUNCTIONS AND BASIC DUTIES

Collect and manage all credentialing documents for providers payer enrollment
Register providers with CAQH, along with managing organization linkage
Submit enrollment applications to insurance companies and follow-up until enrollment is completed
Keep up to date provider enrollment processes and track provider participation levels
Complete re-credentialing for established providers as required by payers
Enter and maintain all Provider information in the credentialing database
Meet required turnaround times and accuracy rates
Perform ongoing research to correct data so it does not create duplicate provider, locations, payees, and participations
Interacts with physicians, physician office personnel, hospital personnel, insurance company personnel and patients demonstrating superior customer service
Maximizes the use of available technologies to improve revenue cycle workflow and maximize collections
Performs other duties as necessary or assigned
Conducts job duties in accordance with the Corporate Values and Culture - Others First - Others before self - Wisdom - Do the wise thing - Growth - Keep getting better

QUALIFICATIONS - EDUCATION, WORK EXPERIENCE, CERTIFICATIONS:

Education/Certification:

High School Diploma or equivalent Experience preferred
0-3 years of experience in provider enrollment

KNOWLEDGE, SKILLS, AND ABILITIES:

Knowledge of medical insurance carrier policies and procedures, and State and Federal rules and regulations
Medicare, Medicaid, and Commercial Payer Provider Enrollment knowledge
Knowledge of PECOS
Working knowledge for CMD Skills/abilities
Strong organizational, planning, and decision-making skills
Ability to adapt to a changing environment
Strong written and verbal communication skills
Ability to work effectively in a fast-paced environment
Proficiency in Microsoft Office, particularly Excel and Word
Professional written and verbal communication and interpersonal skills require
Ability to effectively communicate with team members, supervisors, client staff and insurance contacts
Ability to maintain complete confidentiality in handling sensitive enrollment issues

EEO Statement

Premier Anesthesia 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.

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