Provider Enrollment Specialist/Practice | PCG Admin. Job

Summary

Responsible for all aspects of credentialing and re-credentialing processes for the employed providers in relationship to participation with healthcare plans and hospitals for privileges.  Models appropriate behavior as exemplified in MLH Mission, Vision and Values.

Education/Experience/Licensure

Knowledge/Skills/Abilities

• Knowledge of insurance payer market as it relates to the Memphis area.
• Knowledge of medical and professional credentialing processes including provider enrollment with the various payers and privilege appointments with various hospitals.
• Skill and proficiency with Microsoft Word and Excel.
• Skill and proficiency with computer systems and applications related to practice management systems and credentialing software.
• Ability to function with minimal supervision.
• Strong verbal and written communication skills.
• Ability to prioritize and manage multiple tasks efficiently and accurately.
• Strong organizational skills and must be detail oriented.
• Demonstrated deductive reasoning and ability to use reference materials.

Key Job Responsibilities

• Ensures enrollment is submitted to third party payers within defined time frame.
• Performs various clerical functions related to the credentialing process.

Physical Requirements

• The physical activities of this position may include climbing, pushing, standing, hearing, walking, reaching, grasping, kneeling, stooping, and repetitive motion.
• Must have good balance and coordination.
• The physical requirements of this position are: light work - exerting up to 25 lbs. of force occasionally and/or up to 10 lbs. of force frequently.
• The Associate is required to have close visual acuity to perform an activity, such as preparing and analyzing data and figures; transcribing; viewing a computer terminal; or extensive reading.

• The conditions to which the Associate will be subject in this position: The Associate is not substantially exposed to adverse environmental conditions; job functions are typically performed under conditions such as those found in general office or administrative work.

• Occasional travel to other facilities.