Current jobs related to Provider Enrollment Specialist - Memphis - Radiation Business Solutions

  • Provider Credentialing

    3 months ago

    Memphis, United States University Clinical Health Full time

    Job Type Part-time Description Who We Are: As the only independent and physician-led faculty practice plan of the University of Tennessee Health Science Center, University Clinical Health (UCH) offers best-in-class clinical care through a network of 175+ providers across 19 specialties to meet the healthcare needs of the Mid-South community. UCH is a...

  • Senior Payer Enrollment Specialist

    3 weeks ago

    Memphis, Tennessee, United States Baptist Memorial Healthcare Corporation Full time

    Job SummaryPosition: Specialist-Payer Enrollment SeniorFacility: BMG - Central Business OfficeDepartment: MG CBO CredentialingCategory: Finance and AccountingType: Non ClinicalWork Type: PRNWork Schedule: DaysLocation: US:TN:MemphisAbout the RoleWe are seeking a highly skilled and experienced Specialist-Payer Enrollment Senior to join our team at Baptist...

  • Dual Enrollment Program Specialist

    1 week ago

    Memphis, Tennessee, United States The Tennessee Board of Regents Full time

    Job SummaryThe Tennessee Board of Regents is seeking a highly motivated and organized Dual Enrollment Program Specialist to join our team. As a key member of our Recruitment and K-12 Partnerships department, you will be responsible for overseeing the enrollment of high school students into our dual enrollment program. This role requires strong communication...

  • Provider Credentialing Specialist

    3 days ago

    Memphis, Tennessee, United States University Clinical Health Full time

    Provider Credentialing and Enrollment SpecialistAt University Clinical Health, we are seeking a highly organized and detail-oriented Provider Credentialing and Enrollment Specialist to support our team in ensuring timely and accurate credentialing and payer enrollment activities for our providers.Key Responsibilities:Perform online primary source...

  • Senior Payer Enrollment Specialist

    1 week ago

    Memphis, Tennessee, United States Baptist Memorial Full time

    Job SummaryWe are seeking a highly skilled Senior Payer Enrollment Specialist to join our team at Baptist Memorial Health Care. This role will be responsible for the collection and review of credentialing documents to ensure the accuracy of all enrollment applications and re-credentialing documents submitted to payers.Key Responsibilities:Maintain current...

  • Senior Payer Enrollment Specialist

    2 weeks ago

    Memphis, Tennessee, United States Baptist Memorial Full time

    Job SummaryAs a Senior Payer Enrollment Specialist at Baptist Memorial Health Care, you will play a critical role in ensuring the accuracy of enrollment applications and re-credentialing documents submitted to payers. Your expertise will be essential in supporting the Manager and Director in confirming credentials and primary data source verifications of...

  • Provider Credentialing Specialist

    1 week ago

    Memphis, Tennessee, United States University Clinical Health Full time

    Job Summary:University Clinical Health is seeking a skilled Provider Credentialing Specialist to support the credentialing and payer enrollment activities of our healthcare providers. The ideal candidate will possess strong organizational and critical thinking skills, with a working knowledge of payer enrollment standards and credentialing software.Key...

  • Provider Credentialing Specialist

    1 week ago

    Memphis, Tennessee, United States University Clinical Health Full time

    Job DescriptionAt University Clinical Health, we are seeking a skilled Provider Credentialing Specialist to support our team in ensuring the timely and accurate credentialing and payer enrollment of our healthcare providers.Key Responsibilities:Perform online primary source verification of NPDB, TN and out-of-state professional licenses, DEA certification,...

  • Senior Payer Enrollment Specialist

    1 week ago

    Memphis, Tennessee, United States Baptist Memorial Healthcare Corporation Full time

    Job Summary: Baptist Memorial Health Care Corporation is seeking a highly skilled Senior Payer Enrollment Specialist to join our team. As a key member of our credentialing team, you will be responsible for the collection and review of credentialing documents to ensure the accuracy of all enrollment applications and re-credentialing documents submitted to...

  • Specialist-Payer Enrollment Senior

    4 weeks ago

    Memphis, United States Baptist Memorial Healthcare Corporation Full time

    Summary Responsible for the collection and review of credentialing documents to ensure the accuracy of all enrollment applications and re-credentialing documents submitted to payers. Support the Manager and Director in the efforts to confirm the credentials and primary data source verifications of physicians and mid-level providers joining Baptist Medical...

  • Specialist-Payer Enrollment Senior

    2 weeks ago

    Memphis, United States Baptist Memorial Full time

    Summary Responsible for the collection and review of credentialing documents to ensure the accuracy of all enrollment applications and re-credentialing documents submitted to payers. Support the Manager and Director in the efforts to confirm the credentials and primary data source verifications of physicians and mid-level providers joining Baptist Medical...

  • Vice President of Enrollment Management and Student Affairs

    2 weeks ago

    Memphis, Tennessee, United States Baptist Memorial Healthcare Corporation Full time

    Job SummaryThe Vice President of Enrollment Management and Student Affairs is a key leadership position responsible for overseeing the University's enrollment management and student affairs functions. This role requires a strategic thinker with a proven track record of driving enrollment growth and improving student outcomes.Key ResponsibilitiesLead the...

  • Vice President of Enrollment Management and Student Affairs

    1 week ago

    Memphis, Tennessee, United States Baptist Memorial Healthcare Corporation Full time

    Job SummaryThe Vice President of Enrollment Management and Student Affairs is a senior leadership position responsible for overseeing the University's enrollment management and student affairs operations. This role entails directing and coordinating the functions of the deans and directors of admissions, the Blue Healer Student Success Center (BHSSC),...

  • Vice President of Enrollment Management and Student Affairs

    1 month ago

    Memphis, Tennessee, United States Baptist Memorial Healthcare Corporation Full time

    Job SummaryThe Vice President-Enrollment Management & Student Affairs position at Baptist Memorial Health Care Corporation is a key leadership role that oversees the University's enrollment management and student affairs functions. This includes directing and coordinating the activities of deans and directors, as well as overseeing the Blue Healer Student...

  • Dual Enrollment Teacher

    4 weeks ago

    Memphis, Tennessee, United States Gestalt Community Schools Full time

    Job OverviewAt Gestalt Community Schools, we are seeking a dedicated and passionate educator to join our team as a Dual Enrollment Teaching As a Profession Teacher. This role is an exciting opportunity to make a meaningful impact on the lives of our scholars and contribute to the growth and development of our community.Key ResponsibilitiesDevelop and...

  • Direct Market Manager

    4 days ago

    Memphis, Tennessee, United States ThinkTank Full time

    ThinkTank Telecom, LLC is seeking a results-driven Direct Market Manager to spearhead our expansion efforts in Memphis, TN. As the key driver of our mission to enhance connectivity, your role will focus on enrolling new customers into Lifeline and ACP services, managing inventory, and driving significant sales performance in your designated territory.Key...

  • HSPD-12 Compliance Specialist

    2 weeks ago

    Memphis, Tennessee, United States Citizant Full time

    Job Title: HSPD-12: Government BadgingAbout the Role:Citizant is seeking a highly organized and detail-oriented individual to join our team as a HSPD-12: Government Badging specialist. In this role, you will be responsible for managing the enrollment process for Personal Identity Verification (PIV) cards, ensuring the accuracy and security of applicant...

  • Government Badging Specialist

    2 weeks ago

    Memphis, Tennessee, United States Citizant Full time

    Job DescriptionCitizant is seeking a highly skilled and detail-oriented individual to join our team as a Government Badging Specialist. As a key member of our enrollment process team, you will be responsible for managing the enrollment process for Personal Identity Verification (PIV) cards, ensuring the accuracy and efficiency of the...

  • Administrative Support Specialist

    2 weeks ago

    Memphis, Tennessee, United States Gestalt Community Schools Full time

    Job SummaryGestalt Community Schools is seeking a highly organized and detail-oriented Administrative Support Specialist to join our team. The successful candidate will provide administrative support to our school office, ensuring a smooth and efficient operation.Key ResponsibilitiesProvide exceptional customer service to students, parents, and staff,...

  • HSPD-12 Government Badging Specialist

    1 month ago

    Memphis, Tennessee, United States Citizant Full time

    Job Title: HSPD-12 Government BadgingCitizant is seeking a highly skilled and detail-oriented individual to join our team as a HSPD-12 Government Badging Specialist. In this role, you will be responsible for managing the enrollment process for Personal Identity Verification (PIV) cards, ensuring the accuracy and security of sensitive information.Key...

Provider Enrollment Specialist

2 months ago

Memphis, United States Radiation Business Solutions Full time

Job Type

Full-time

Description

The Provider Enrollment Specialist administers the physician enrollment application process for payor enrollment. The Provider Enrollment Specialist is responsible for timely completion of government, managed care and commercial payor enrollment applications, via paper or on-line records and reporting demographic or other provider changes.

The Provider Enrollment Specialist will be responsible for the accuracy and integrity of the database system and related applications. Working under the supervision of the Credentialing Team Lead they must be able to handle multiple, simultaneous tasks effectively and efficiently and are expected to demonstrate ENCORE in all communications.

Essential Duties and Responsibilities

Reduce onboarding time for new providers by 5% annually

Maintain files, no "dropped" recredentialing

Lead, coordinate, and perform the review and analysis of practitioner applications and accompanying documents, ensuring applicant eligibility

Conduct thorough review, research, and primary source verification for licensing, board certifications, proof of professional liability insurance, and/or other sources as required based on NCQA standards, health plan requirements, and company credentialing policies

Update and maintain all external credentialing systems including CAQH, PECOS, Availity, and other required payer platforms

Complete enrollment with all clients contracted payers including Medicare, Medicaid, and other government and managed care plans for new client providers, groups and/or locations

Ensure initial credentialing and re-credentialing applications are completed and sent within defined departmental standards.

Ensure Medicare, Medicaid, and other payer revalidations/recredentialing applications are completed timely without lapse in enrollment.

Provide consistent and timely follow-up on all assigned outstanding items.

Respond to inquiries from internal and external customers on day-to-day credentialing and privileging issues as they arise

Enter, update, and maintain all internal credentialing databases; prepare and provide information to internal and external customers as appropriate.

Process provider demographic changes ensuring appropriate documentation has been submitted with the changes, update credentialing databases, and notify health plans of changes.

Monitor initial, reappointment and expirable process for all RBSE clients, RBSE licensed staff and RBSE partners and delegated providers, ensuring compliance with regulatory bodies (Joint Commission, CMS, federal and state), as well as Bylaws, Rules and Regulations, policies and procedures, and delegated contracts

Complete thorough review of all client contracts and contract amendments ensuring that client rates are unaffected and provide the best possible reimbursement and procedures for the client.

Interact not only with payers, but also with clients, providers, vendors, RCM team, and other business partners in a professional and positive manner.

Familiarity with RBS Revenue Cycle Structure - Clients and Physicians

Reviews processes and provides suggestions for process improvements and efficiencies.

Other Expectations/Skills

A collaborative approach to assisting clients and staff.

Self-motivated with the ability to problem solve.

Reliable and extremely trustworthy.

Program planning and implementation skills.

Database management.

Ability to maintain confidential and meticulous records.

Excellent verbal and written communication skills.

Proficient in Microsoft Office Suite or related software.

Exceptional organizational skills and attention to detail.

Superior analytical and technical skills.

Excellent keyboarding and administrative skills.

Other duties include follow-up on open applications with providers or payors.

ENCORE Values

Encourage others' success

New ideas; anticipate problems: Contribute to team's efficiency by participating in staff meetings and contributing new thoughts and ideas for process improvements. Identify issues that require additional investigation and evaluation, validate discrepancies, and ensure appropriate follow-up.

Create financial value for our clients: Maintain up-to-date Credentialing Payer Grids for each Client showing all contracted payers, providers, and effective dates. The Gold Standard is to achieve aging goals in the same month 4 out of 6 rolling months.

  • No missed or expired Medicare/Medicaid Revalidations for the calendar year.
  • No items aging over 180 days.
  • Aging goal for Open Items over 90 days is below 20% of total open items.
  • Aging goal for Open Items over 120 days is less than 10% of total open items.
  • Obtain 90% approval rating from client satisfaction surveys obtained.

Ownership towards a solution: Identify issues that fall through the cracks, either here or on the client side, before they create problems; use critical thinking skills to provide remedial solutions and develop preventive methods going forward. Ensure provider credentialing procedures are followed, and timelines are met to prevent loss of revenue.

Reach Life Balance

Embody a positive approach: Actively engage in departmental, client, and other internal team meetings with a positive and upbeat attitude. Communication with clients and other RBS divisions should be positive and show an "I can" approach

Requirements

College degree or equivalent experience.

3+ years of experience performing credentialing and provider enrollment services typically gained in a hospital or physician's office preferred

Computerized practice management/credentialing systems and software preferred

CPCS (Certified Provider Credentialing Specialist) from NAMSS (National Association Medical Staff Services). Expected to have or obtain within one year of hire date.

Physical Demands and Work Environment: The physical demands described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the functions.

Ability to lift/carry up to 25 pounds.

Ability to sit/stand for long periods of time.

Good manual dexterity with the ability to perform repetitive hand/wrist motions.

Requires mastery of complex language, comprehension, reasoning, and analytical skills typically found in mid to high-level work.

Typical office environment

Moderate noise levels

Disclaimer: This job description in no way states or implies that these are the only duties to be performed by the employee(s) of this position. Employees will be required to follow any other job-related instructions and to perform any other job-related duties requested by any person authorized to give instructions or assignments. All duties and responsibilities are essential functions and requirements and are subject to possible modification to reasonably accommodate individuals with disabilities.

The company is an equal opportunity employer, drug-free workplace, and complies with ADA regulations as applicable.