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Provider Enrollment Specialist

2 months ago

Louisville, Kentucky, United States BrightSpring Health Services Full time
Job Summary

As a Provider Enrollment Manager at BrightSpring Health Services, you will play a critical role in ensuring the company's compliance with government regulations and legal requirements. You will be responsible for compiling, submitting, and tracking Medicare, Medicaid, and private payer provider applications, as well as re-validations and re-credentialing applications. Your attention to detail and ability to work with multiple stakeholders will be essential in maintaining accurate and complete provider applications.

Key Responsibilities

  • Compile and submit provider applications, re-validations, and re-credentialing applications to ensure compliance with government regulations and company policies.
  • Coordinate and maintain a tracking system for provider contracts and re-validation, re-credentialing, and enrollment applications and correspondence.
  • Revalidate and re-certify business entities via application.
  • Assist with M&A integration, ensuring correct entity enrollment and preventing lapses in billing.
  • Answer field questions about ownership surveys, legal entities, and sanctions.
  • Supervise the provider enrollment specialist.
  • Adhere to company and governmental guidelines regarding confidential and protected health information.


Requirements

  • General Education Diploma or High School Diploma required.
  • Bachelor's degree preferred.
  • Two plus years of experience required.
  • Familiarity with government regulations and legal research.
  • Knowledge of the Medicaid and Medicare programs.


About BrightSpring Health Services

BrightSpring Health Services provides comprehensive and integrated home- and community-based pharmacy and health solutions for complex populations in need of specialized and/or chronic care. Through our service lines, including pharmacy, home health care, and primary care, and rehabilitation and behavioral health, we provide clinical solutions in all 50 states to over 400,000 customers, clients, and patients daily. For more information, visit https://www.brightspringhealth.com/.