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Provider Enrollment Maintenance Representative in Tamarac, FL at TeamHealth

Date Posted: 10/22/2018

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    Tamarac, FL
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
    10/22/2018

Job Description

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 off’s/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.

  • 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
    • Recredentialing 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 form updates requires in AppGen
  • 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

  • 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
  • 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