Enrollment Specialist 2, Managed Care Network, FT, 8:30A-5P
About The Position
Complete new, revalidation and informational updated enrollment applications for participation in government funded payment programs for all Baptist Health Medical Group (BHMG) employed physicians and Baptist Health South Florida (BHSF) facilities with the Medicare, Medicaid and all contracted commercial insurance plans. Corresponds and maintains positive relationships with managed care insurance payors and serves as a central point of contact regarding managed care insurance/payor issues in relation to BHMG employed physicians. Communicates with Medicare Administrative Contactor, fiscal intermediary and contractors for all government payer programs outside the state of Florida and within on behalf of BHSF. To assure all applications, documentation and information necessary for proper compliant reimbursement are up to date, and maintained in proper status.
Requirements
- Associates degree
- NAMSS Certified Professional Credentialing Specialist
- At least 10 or more years experience in a healthcare setting
- Five years experience in a hospital business office, knowledge of billing and reimbursement regulations governing government funded programs
- NAMSS CPCS/CPCSM certification OR Equivalent work experience
- Experience in a managed care related position dealing directly with payors, providers and /or contracts
- Strong critical thinking skills
- Ability to analyze data
- Excellent writing and interpersonal skills
- Strong working knowledge of CAQH, PECOS, NPPES required
- Proficient in MS Office including Word, Excel and PowerPoint
- Strong organizational skills and attention to detail necessary
- Ability to formulate decisions and execute a plan of action
- Minimum Required Experience: 5 Years
Responsibilities
- Complete new, revalidation and informational updated enrollment applications for participation in government funded payment programs for all Baptist Health Medical Group (BHMG) employed physicians and Baptist Health South Florida (BHSF) facilities with the Medicare, Medicaid and all contracted commercial insurance plans.
- Corresponds and maintains positive relationships with managed care insurance payors and serves as a central point of contact regarding managed care insurance/payor issues in relation to BHMG employed physicians.
- Communicates with Medicare Administrative Contactor, fiscal intermediary and contractors for all government payer programs outside the state of Florida and within on behalf of BHSF.
- Assures all applications, documentation and information necessary for proper compliant reimbursement are up to date, and maintained in proper status.
Benefits
- Career growth and development opportunities, with clear pathways and ongoing support
- Comprehensive health and wellness resources that go beyond traditional benefits
- A wellness program that can help employees eliminate their medical plan deductible, reducing out-of-pocket healthcare costs
- Tuition reimbursement to support continued learning and advancement
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
