What are the responsibilities and job description for the Specialist-Payer Enrollment position at Baptist Memorial Health Care?
Overview
Job Summary
Generates enrollment or affiliation applications to submit per established protocols. Reviews for accuracy all enrollment applications and re-credentialing documents prior to submission. Follows established workflows to ensure that proper enrollments are submitted and that timely follow up is performed. This includes prompt response to follow up requests from payers or facilities. Assists in continuous reevaluation of workflows to ensure efficient processes are being followed. Supports 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 Group. Communicates directly with providers, payers, clinic personnel, Operation Directors and Managers and Executive Directors as needed. Generates reports. Performs data entry. Performs primary data source verification. Performs CAQH attestation. Each function requires the highest level of accuracy and confidentiality. Performs other duties as assigned.
Responsibilities
Experience
Education
Minimum Required
Minimum Required
Special Skills
Minimum Required
Preferred/Desired
Minimum Required
Job Summary
Generates enrollment or affiliation applications to submit per established protocols. Reviews for accuracy all enrollment applications and re-credentialing documents prior to submission. Follows established workflows to ensure that proper enrollments are submitted and that timely follow up is performed. This includes prompt response to follow up requests from payers or facilities. Assists in continuous reevaluation of workflows to ensure efficient processes are being followed. Supports 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 Group. Communicates directly with providers, payers, clinic personnel, Operation Directors and Managers and Executive Directors as needed. Generates reports. Performs data entry. Performs primary data source verification. Performs CAQH attestation. Each function requires the highest level of accuracy and confidentiality. Performs other duties as assigned.
Responsibilities
- Maintains current knowledge of credentialing practices and standards.
- Completes government and commercial insurance enrollment applications for new and established providers within BMG and BMG Foundations.
- Providers excellent service to all customers: patients, providers, payers, clinic staff, Physician Revenue Cycle staff, Operations and Administration.
- Maintains current licensure, DEA, certifications, board certifications and all other credentialing documents.
- Reviews EPIC's related to payer enrollment on a daily basis.
- Completes assigned goals.
Experience
- #N/A
- 2 years focused credentialing experience in a medical billing organization.
Education
Minimum Required
- High School/GED
- Medical Billing and Coding Diploma from an accredited facility.
Minimum Required
- Proficient in Microsoft Office. Ability to type 35 wpm
Special Skills
Minimum Required
- Excellent skills in verbal and written communication.
- Working knowledge of CAQH, AMA, NPDB, and primary data source verification. Specific knowledge of payer enrollment application process.
Preferred/Desired
Minimum Required
