Medicaid Provider Enrollment Specialist

4 weeks ago

Brentwood, Tennessee, United States HCA Healthcare Full time

Description

Introduction

Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a Provider Enrollment Specialist with Parallon you can be a part of an organization that is devoted to giving back

Benefits

Parallon, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

  • Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
  • Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
  • Free counseling services and resources for emotional, physical and financial wellbeing
  • 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
  • Employee Stock Purchase Plan with 10% off HCA Healthcare stock
  • Family support through fertility and family building benefits with Progyny and adoption assistance.
  • Referral services for child, elder and pet care, home and auto repair, event planning and more
  • Consumer discounts through Abenity and Consumer Discounts
  • Retirement readiness, rollover assistance services and preferred banking partnerships
  • Education assistance (tuition, student loan, certification support, dependent scholarships)
  • Colleague recognition program
  • Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
  • Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

Would you like to unlock your potential with a leading healthcare provider dedicated to the growth and development of our colleagues? Join the Parallon family We will give you the tools and resources you need to succeed in our organization. We are looking for an enthusiastic Provider Enrollment Specialist to help us reach our goals. Unlock your potential

Job Summary and Qualifications

Seeking a Provider Enrollment Specialist who is responsible for processing enrollments for new and existing individual providers and group practices, such as initiating new enrollments with Commercial and Governmental payors and reporting demographic or other provider changes. Other duties include follow-up on open applications with providers or payors, including escalation to the Provider Enrollment Account Management team or Strategic Pricing and Analytics (SPA) Managed Care Team for resolution. We are an amazing team that works hard to support each other and are seeking a phenomenal addition like you. We want you to apply today

What you will do in this role:

  • Ensure provider participation with contracted payors by taking appropriate next actions to complete enrollment, such as completing applications, rosters, and notifications
  • Monitor inventory
  • Escalate items to other areas outside of department as needed
  • Work with payors and providers to ensure compliance with enrollment process
  • Initiate contact with payors and practices via telephone or electronic methods with respect to provider enrollment and billing errors, utilizing proper customer service protocol
  • Update and maintain data in appropriate Provider Enrollment systems while ensuring accuracy and data integrity
  • Review correspondence received and perform appropriate action to resolve
  • Appropriately resolve or escalate payor application denials
  • Meet and maintain established departmental performance metrics for production and quality
  • Maintain working knowledge of workflow, systems, and tools used in the department

What qualifications you will need:

  • High school diploma or GED preferred
  • 1 year of related experience in Medicaid Enrollment, Managed Care Enrollment, or Provider Enrollment
  • Relevant education may substitute experience requirement
  • Knowledge of National Plan and Provider Enumeration System (NPPES) and Council for Affordable Quality Healthcare (CAQH) preferred

"

Parallon provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities.

HCA Healthcare has been recognized as one of the World's Most Ethical Companies by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated 3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

"

"There is so much good to do in the world and so many different ways to do it."- Dr. Thomas Frist, Sr.

HCA Healthcare Co-Founder

Be a part of an organization that invests in you We are reviewing applications for our Provider Enrollment Specialist opening. Qualified candidates will be contacted for interviews. Submit your application and help us raise the bar in patient care

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

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