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Provider Enrollment Maintenance Coordinator in Sunrise, FL at TeamHealth

Date Posted: 1/10/2022

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    Sunrise, FL
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
    1/10/2022

Job Description

TeamHealth is a physician-led, patient-focused company. Founded by doctors, for doctors, our success stems from the ingenuity, dedicated teamwork and integrity of our people. Our non-clinical associates are the ones that make TeamHealth tick. Whether you have your eye on the home office or one of our locations around the country, you can find your place here.

JOB DESCRIPTION OVERVIEW:

The Provider Enrollment Maintenance Representative is responsible for proactively completing all provider enrollment maintenance activities. This position is responsible for minimizing any lapses in clinician enrollment and write offs/holds related to maintenance activities. This position is responsible for verifying maintenance requirements, ensuring centralized payer library is current and communicating updates to management and colleagues.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Complete all maintenance activities including research, recording, communication & information sharing, submission, confirmation and follow-up
  • Maintenance activities include, but are not limited to:
    • Medicare & Medicaid revalidations
    • Re-credentialing for all payers
    • Creation and maintenance of CAQH practice and clinician profiles
    • Submission of clinician updates e.g. licensure and certificates of insurance to payers
    • Completion of any/all requests for data validation from payers and internal customers
    • Manage roster submission, review and data entry
    • Collaborate with colleagues to resolve enrollment related denials associated with maintenance
    • Collaborate with analyst and/or HCFS to proactively monitor enrollment status for payers that require claim activity to remain participating
    • Partner with Lead to communicate any application, roster or payer required form updates Application Generation software
    • Partner with Manager to communicate any payer maintenance activity updates required in the payer library
    • Occasional overtime and/or participation on special projects may be required
    • Other duties as assigned

 

 

Job Requirements

QUALIFICATIONS / EXPERIENCE: 

  • Ability to operate effectively in a fast paced environment
  • Demonstrate a systematic approach in carrying out assignments; methodical in planning and performing; effective prioritization required
  • Display a high standard of professional conduct to include punctuality, job consciousness and dependability
  • Perform with a high degree of accuracy; give meticulous attention to detail
  • Work harmoniously and effectively across all levels of the business; cooperate with others for the benefit of the organization
  • Communicate clearly, concisely, positively and professionally
  • Show genuine interest in continuous development in professional and technical skills
  • High school diploma or equivalent; some college preferred
  • One year of experience with health care or comparable industry