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Provider Enrollment Specialist

Company: American Physician Partners
Location: Brentwood
Posted on: January 16, 2022

Job Description:

American Physician Partners has an opportunity to join our growing Operations team in Brentwood, TN.

Job Duties:
Ensure provider participation with contracted payor by taking appropriate actions to complete enrollment
Work with payors and providers to ensure compliance with enrollment process
Review active roster to ensure all providers have payor numbers and/or going through the enrollment process
Meet with Representatives from Credentialing and Recruiting Departments so all potential and signed providers are going through the PE process
Create and maintain proper tracking/workflow in the Provider Enrollment software application
Meet and maintain established department metrics for production and quality
Review correspondence received from payor and providers and perform appropriate action to resolve
Appropriately resolve or escalate payor application denials
Maintain working knowledge of workflow, systems and tools used in the department
Other duties as necessary to support the success of the Provider Enrollment Department

Requirements:
Minimum three years related healthcare experience, such as Medicare/Medicaid enrollment or Managed Care enrollment.
Knowledge of Governmental and Commercial Payor processes and guidelines.
Knowledge of NPPES and CAQH required.
High school diploma or equivalent required
Associates degree preferred
At least 3 years of health care experience
Basic computer and keyboarding skills
Strong verbal and written communication skills required
Proficient use of Microsoft Office applications

Compensation
Aggressive salary
Full Benefits
Paid Time Off
Advancement Opportunities

Keywords: American Physician Partners, Nashville , Provider Enrollment Specialist, Other , Brentwood, Tennessee

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