Specialist-Payer Enrollment

Baptist • Memphis, TN

1d

About The Position

Generates enrollment or affiliation applications to submit per established
protocols. Reviews for accuracy all enrollment applications and re-credentialing
documents prior to submission. 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 or facilities.
Assists in continuous reevaluation of workflows to ensure efficient processes
are being followed. Supports the Manager and Director in the efforts to confirm
the credentials and primary data source verifications of physicians and
mid-level providers joining Baptist Medical Group. Communicates directly with
providers, payers, clinic personnel, Operation Directors and Managers and
Executive Directors as needed. Generates reports. Performs data entry. Performs
primary data source verification. Performs CAQH attestation. Each function
requires the highest level of accuracy and confidentiality. Performs other
duties as assigned.

Requirements

• 2 years focused credentialing experience in a medical billing organization.
• High School/GED
• Proficient in Microsoft Office. Ability to type 35 wpm
• Excellent skills in verbal and written communication.

Nice To Haves

• Medical Billing and Coding Diploma from an accredited facility.
• Working knowledge of CAQH, AMA, NPDB, and primary data source verification.
• Specific knowledge of payer enrollment application process.

Responsibilities

• Maintains current knowledge of credentialing practices and standards.
• Completes government and commercial insurance enrollment applications for new and established providers within BMG and BMG Foundations.
• Providers excellent service to all customers: patients, providers, payers, clinic staff, Physician Revenue Cycle staff, Operations and Administration.
• Maintains current licensure, DEA, certifications, board certifications and all other credentialing documents.
• Reviews EPIC's related to payer enrollment on a daily basis.
• Completes assigned goals.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED
• Number of Employees: 1,001-5,000 employees