Position: Manager ,Provider Enrollment Job Code: PES
Department: Provider Enrollment FLSA Status: Exempt
Reports To: VP, Ancillary Services
Job Summary
The Provider Enrollment Manager can function independently as well as a part of a team, working to prioritize projects appropriately. Responsibilities include preparing and submitting applications and supporting documentation for the purpose of enrolling individual physicians and physician groups with payers. Working closely with leadership and clients, to ensure that detailed reports and feedback occur in a proactive manner.
Qualifications
- Bachelor’s degree in a related field and/or the equivalent combination of training, education, and experience, required
- 5-10 Years Provider Enrollment experience required
- 5-10 years progressive healthcare experience, required
- 5+ years of leadership/training experience required
- Expert level knowledge of Microsoft Office (Word and Excel) required
- Excellent written and verbal communication skills
- Strong organization skills, ability to function independently, prioritizing tasks to meet deadlines
- CPCS and/or CPMSM certification and hospital privileging knowledge preferred
- Knowledge of risk management and HIMS experience
- Progressive experience working with medical staff leadership and senior management
- Strong organization skills, ability to function independently, prioritizing tasks to meet deadlines.
Responsibilities
- Maintain documentation and reporting regarding provider enrollments in process
- Retain records related to completed provider enrollments
- Maintain provider enrollment information within the credentialing database
- Interact professionally with providers, ancillary staff, and plan representatives to provide appropriate and timely response to inquiries and concerns regarding provider
- Respond professionally to client inquiries regarding status of applications received
- Proactive follow up with insurance plans to monitor status of provider applications
- Research and contact providers to resolve enrollment application deficiencies
- Send out provider applications, forms and other provider correspondence as requested
- Maintain strict confidentiality of information as dictated by current HIPAA requirements
- Collaborate with leadership and teammates on process improvement
- Obtain and/or enter information in a timely and efficient manner
- Lead and/or Actively Participate in client and departmental meetings
- Account for internal control responsibilities in line with the organization’s objectives
- Ability to handle Protected Health Information in a manner consistent with the Health Insurance Portability and Accountability Act (HIPAA)
- Other duties as assigned
Work Environment/Physical Demands/Travel Requirements
- In office-100% onsite
- Ability to sit and type at a computer terminal for long periods of time
- Travel: Up to 10% as needed
Job Type: Full-time
Benefits:
- 401(k)
- Dental insurance
- Disability insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Day shift
- Monday to Friday
Ability to Commute:
- Louisville, KY 40202 (Required)
Ability to Relocate:
- Louisville, KY 40202: Relocate before starting work (Required)
Work Location: In person