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Provider Enrollment Specialist in Tamarac, Florida, US at TeamHealth

Date Posted: 11/6/2019

Job Snapshot

Job Description

JOB DESCRIPTION OVERVIEW:
Under supervision of the Provider Enrollment Manager, the Provider Enrollment Specialist manages the application process of new and incumbent providers with all applicable commercial payers.


ESSENTIAL DUTIES AND RESPONSIBILITIES:
• Manages the successful completion and submission of provider enrollment applications.
• Understands specific application requirements for each payer including pre-requisites, forms required, form completion requirements, supporting documentation and regulations
• Maintains documentation and reporting regarding provider enrollments in process; performs follow-up as necessary
• Works closely with credentialing staff and member hospitals to expedite completion of forms and requirements including obtaining signatures, locating required documentation, etc.
• Ensures that established provider IDs and effective dates are communicated to appropriate billing and revenue departments so claims can be processed for submission.
• Establishes and maintains close working relationships within department and with various departments across organization

 

Job Requirements

QUALIFICATIONS / EXPERIENCE:

  • HS Diploma or equivalent; some college preferred
  • One (1) year of experience with contracts, legal documents or other healthcare-related work
  • Proficient in Microsoft Office applications
  • Ability to make decisions and solve problems
  • Superior communication skills (verbal and written)
  • Ability to communicate effectively with Providers, Medical Directors and VPOs
  • Excellent organizational skills with the ability to prioritize and manage multiple projects; meticulous accuracy
  • Ability to meet challenging deadlines
  • Ability to function in stressful situations
  • Ability to work in a team environment
  • Overtime may be required; some training and seminar attendance may require overnight travel


PHYSICAL / ENVIRONMENTAL DEMANDS:

  • General office environment
  • Job performed in a well-lighted, modern office setting
  • Occasional lifting/carrying (10 pounds or less)
  • Prolonged sitting; with prolonged work in a computer/PC
  • Occasional work in evenings and on weekends
  • Moderate stress
  • May require moderate overnight travel
  • Overtime may be required and can be mandated by Management
  • Ability to work well in fast-paced environment

This position may require manual dexterity and/or frequent use of the computer, telephone, 10-key, calculator, office machines (copier, scanner, fax) and/or the ability to perform repetitive motions and/or meet production standards to comply with the essential functions. Also, may require physical
and/or mental stamina to work overtime, additional hours beyond a regular schedule and/or more than five days per week.


DISCLAIMER:
The above information on this description has been designated to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of employees assigned to this job. Cooperative, positive, courteous and professional behavior and conduct is an essential function of every position. All employees must be able to work with others beyond giving and receiving instructions. This includes getting along with co-workers, peers and management without exhibiting behavior extremes. Job functions may require personal leadership skills such as conflict resolution, negotiating, instructing, persuading, speaking with others as well as responding appropriately to job
performance feedback from the supervisor. Additionally, the information contained in this job description has been designated to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this
position.