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Provider Enrollment Operations Account Manager

4 months ago

Nashville, United States TriStar Centennial Medical Center Full time

Description

This position is incentive eligible.

Introduction

Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a Provider Enrollment Account Manager 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 Account Manager to help us reach our goals. Unlock your potential

Job Summary and Qualifications

The Provider Enrollment Account Manager is responsible for providing supervision and oversight of the enrollment process. The Account Manager works closely with department managers and staff in their day-to-day responsibilities and enrollment contacts to ensure timely notifications of new providers and provider changes. The Account Manager also serves as a liaison between the practice, managed care, payor, and provider enrollment department to ensure timely notification of new providers, provider changes, prompt processing of applications, and oversight of the enrollment process including escalations. Proficient in facilitation and interpersonal communication, the Account Manager also consistently demonstrates skills in organization, prioritization, professionalism and coaching others.

In this role you will:

  • Oversee the Provider Enrollment process including application/notification submission with Commercial and Government payors and credentialing activities, in coordination with department staff, Managed Care, Credentialing Processing Centers (CPCs)
  • Attend acquisition, initial, and recurring enrollment status calls with practices as needed to ensure seamless transition and implementation
  • Establish and facilitate meetings with Leadership for assigned Division enrollment review
  • Communicate enrollment updates to enrollment contacts and senior leadership
  • Respond to provider enrollment customer service inquiries
  • Coordinate and communicate continuously with other departments to share information, best practices, systems issues, process solutions, and training needs
  • Establishes and maintains effective payor relationships
  • Collaboratively works with managed care and the payor until enrollment resolution is reached
  • Prepare and analyze department operating reports
  • Monitor defined reports and coordinate with applicable departments to ensure accounts receivable is properly stated
  • Identify and communicate to management educational opportunities
  • Collaborate with other departments to resolve enrollment or claim issues
  • Work to resolve time-sensitive and customer essential issues that arise on a day to day basis coordinating internal and external resources as necessary.
  • Acts as a liaison between assigned division/markets and Physician Service Center
  • Establish good working relationships with Market/Practice leadership
  • Complete special projects as assigned by management
  • Ensure compliance with company and departmental policies and procedures
  • Proactively review and provide data analysis and financial impact assessments
  • Review aged enrollments to determine root cause and next steps
  • Establish and review internal controls to ensure goals, objectives, standards, and benchmarks for the department are met or exceeded
  • Assist in timely month-end closing activities
  • Ensure training needs are met
  • Conduct enrollment contact, division, and payor meetings
  • Maintain working knowledge of workflow, systems, and tools used in the department

Qualifications:

  • Bachelors Degree in Business or related field required. Equivalent work experience may substitute education requirements
  • Minimum three years experience in related area preferred with two of these years being healthcare management experience or completion of the Parallon Manager Trainee Program.
  • Knowledge of provider enrollment and credentialing process preferred.
  • Experience in the management of projects.
  • Strong customer focus and results driven.
  • Must have experience in Provider Enrollment, Credentialing, Accounts Receivable, Denials, and Insurance Follow up.

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 Worlds 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.

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"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 Mgr PE Acct WFH 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.