Provider Enrollment Specialist | FT | Weekdays | Remote

Methodist Le Bonheur Healthcare • Remote Associate - Mississippi, MS

1d • Remote

About The Position

Responsible for coordinating, monitoring and maintaining the Credentialing and Re-credentialing processes for the employed providers in relationship to participation with healthcare plans and hospitals for privileges. Facilitates and performs all aspects of credentialing, including appointment, re-appointment, monitoring and privileging of the MHMH Medical Staff Members and Allied Health Professionals. Models' appropriate behavior as exemplified in MLH Mission, Vision and Values. Working at MLH means carrying the mission forward of caring for our community and impacting the lives of patients in every way through compassion, a deliberate focus on service expectations and a consistent thriving for excellence.

A Brief Overview
Responsible for coordinating, monitoring and maintaining the Credentialing and Re-credentialing processes for the employed providers in relationship to participation with healthcare plans and hospitals for privileges. Facilitates and performs all aspects of credentialing, including appointment, re-appointment, monitoring and privileging of the MHMH Medical Staff Members and Allied Health Professionals. Models' appropriate behavior as exemplified in MLH Mission, Vision and Values.

What you will do
Facilitates and performs all aspects of provider enrollment including credentialing and re-credentialing of Physicians and Allied Health. Professionals in accordance with the policies and procedures of insurance payers. Tracks and maintains enrollments through timely re-validations. Performs follow-up with insurance payors. Establishes providers’ CAQH (Council for Affordable Quality Healthcare) profiles. Maintains profiles, uploads documents as required, and re-attests. Performs various clerical functions related to the credentialing process.

Requirements

• Bachelor's Degree Healthcare Administration
• Provider Enrollment/Credentialing in a healthcare setting 3-5 years
• Knowledge of insurance payer market as it relates to the Memphis Metropolitan area.
• Knowledge of medical and professional credentialing processes including provider enrollment with the various payers and privilege appointments with various hospitals.
• Skill and proficiency with Symplr, Microsoft Word, Outlook, OneNote and Excel.
• Proficiency in NPPES, PECOS and Availity.
• Strong verbal and written communication skills.
• Ability to handle assignments independently with demonstrated analytical and interpersonal skills.
• Demonstrates ability to maintain excellent customer service skills and customer relations under stressful conditions.
• Ability to function with minimal supervision and communicate effectively with high level Associates within the Provider Enrollment community and their office staff.
• Ability to set priorities, coordinate multiple tasks, organize tasks, and maintain control of workflow.
• Strong organizational skills and must be detail oriented.
• Demonstrated deductive reasoning and ability to use reference materials.

Nice To Haves

• Bachelor's Degree Business Administration
• High School Diploma or Equivalent

Responsibilities

• Facilitates and performs all aspects of provider enrollment including credentialing and re-credentialing of Physicians and Allied Health. Professionals in accordance with the policies and procedures of insurance payers.
• Tracks and maintains enrollments through timely re-validations.
• Performs follow-up with insurance payors.
• Establishes providers’ CAQH (Council for Affordable Quality Healthcare) profiles.
• Maintains profiles, uploads documents as required, and re-attests.
• Performs various clerical functions related to the credentialing process.

Benefits

• The Associate is required to have close visual acuity to perform an activity, such as preparing and analyzing data and figures; transcribing; viewing a computer terminal; or extensive reading.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level