Provider Enrollment Specialist
Provider Enrollment SpecialistWho we are:At Lifepoint Health, we provide quality healthcare to rural communities. As a valued member of our team, you will be an integral part of a group working together to elevate Lifepoint's healthcare delivery network. Our network includes 60 community hospitals, 60 rehabilitation/behavioral health hospitals, and 250 additional sites of care across the United States. As an organization, we are dedicated to serving communities nationwide by providing exceptional care. We believe in the power of our talented teams and strive to create environments where employees find purpose and fulfillment.What you’ll do:The Provider Enrollment Specialist is responsible for requesting participation for providers in and with health plans to minimize the possibility of delay or non-payment of claims for services rendered by practitioners.Responsibilities:
Complete Council for Affordable Quality Healthcare, Inc. (CAQH) credentialing process on new providers.
Follow-up with payers for effective dates, status updates, and identification numbers for provider payment and claims to be released.
Responsible for completing applications, re-credentialing applications, demographic updates and documents to each payer for processing.
Research payers for information on processes to enroll providers, contact representative information and status of provider already in the system or not.
Update, monitor, and maintain CAQH database with all current provider information that is received from the Market Director.
Input and/or maintain data for provider to include but not limited to, initial input of provider demographics, personal, medical documentation, effective dates, and comments.
Maintain updated licenses, add locations and various groups.
Monitor and maintain provider files to determine reason for pending enrollment and/or acknowledge all documents are received; request any documents and user- names/passwords needed for enrollments; routinely update status changes.
Perform routine administrative tasks to include but not limited to, processing applications, uploading and updated documents, notification forms, enroll provider(s) with all designated payers, and research process with payer in a timely manner.
Communicate and provide updates to designated market contacts. Research payer enrollment questions and issues raised by market representative and /or providers and respond with resolution.
Maintain regular and reliable attendance.
Perform other duties as assigned.
Additional Information:
Position serves both internal co-workers and external customers, clients, patients, contractors, and vendors.
Access to and/or works with sensitive and/or confidential information.
Exhibit a [comprehensive] understanding of healthcare regulatory and compliance (e.g., HIPAA). Skilled in the application of policies and procedures. Knowledge of Business Office Standards and Recommended Practices.
What you’ll need:Education:High school diploma or equivalent, or combination of education and experience required for the job.Experience:2 years of experience in Insurance Payer Background and/or Enrollment (preferred).Why choose us: As a team member of the Health Support Center, our goal is to support those that are in our facilities who are interfacing and providing care to our patients and community members. Our focus is to attract, retain, and empower a diverse and determined workforce. Our mission statement is at the heart of who we are and what we do: “Making Communities Healthier.” In this shared mission, we believe that our collective efforts will shape a healthier future for the communities we serve.Benefits:We offer an excellent total compensation package, including a competitive salary and benefits. Some of our benefits include 401k, flexible PTO, generous Employee illness benefit (EIB), medical, dental, vision, tuition reimbursement, and an Employee Assistance Program. We believe that happy, healthy people have a passionate engagement with life and work and have designed our package to enhance your wellbeing.Job: Please select a valid job field Organization: LifePoint Health Support Center Title: Provider Enrollment Specialist Location: Tennessee-Brentwood Requisition ID: 7410-7842