Credentialing & Payer Enrollment Specialist - Buckhead

Alliance Spine and Pain Centers•Atlanta, GA

8d•Onsite

About The Position

We are a thriving Outpatient Pain Management Practice who seeks qualified, dynamic Healthcare Professionals like you! This position requires a strong teamwork orientation, solid verbal & written communication skills, and stellar attention to detail. Responsible for completing defect-free and timely payor enrollment activities for all medical providers who provide patient care at centers and medical practices owned and/or managed by ASPC. Maintain up-to-date data for each provider in online systems such as Qgenda and Smartsheet; ensure timely renewal of all associated applications within the scope of payer enrollment. Works with payors on issues resolution, and provider roster loads.

Requirements

High school diploma or GED required.
Two years of relevant credentialing experience.
Knowledge and understanding of the credentialing process.
Ability to organize and prioritize work and manage multiple priorities.
Excellent verbal and written communication skills including letters, memos and emails.
Excellent attention to detail.

Nice To Haves

Certified Provider Credentialing Specialist (CPCS) preferred.

Responsibilities

Processes internal (ASC) and external (Facilities) credentialing and re-credentialing applications; Primary Source Verification, and monitors applications and follows-up.
Maintains and tracks state licenses, DEA, and other certifications required for credentialing.
Maintains current knowledge of payer enrollment guidelines and standards.
Accurately Review and completes government and commercial payor enrollments for the state of Georgia i.e., Medicare, Medicaid, Commercial carriers, workers comp, and any additional related forms in order to achieve successful enrollment and re-enrollment outcomes in a timely and defect-free manner with payors for new and established providers.
Provider excellent service to all providers, payers, clinic staff, Physician Revenue Cycle staff, Operations and Administration.
Works with payors on issues resolution, and provider roster loads confirmation.
Consistently document work assignment progress, enrollment follow-up status, and relevant in-process tasks within and time frames within Enrollment Software.
Follows established workflows to ensure that proper enrollments are submitted and that timely follow up is performed. This includes prompt response to follow up requests from payers.
Communicates directly with providers, payers, clinic personnel, Operation Directors and Managers and Executive Directors as needed.
Generates reports.
Performs data entry.
Performs CAQH attestation.
Provider File Compliance Maintenance (i.e., JCAHO, State).
Escalates matters that may impede the process of timely enrollment with payors.
Performs other duties as assigned.