Provider enrollment specialist wmcg

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.

Work Shift

Various (United States of America)

Job Summary:

Coordinates and administers the enrollment process for medical providers on behalf of practice plan and AU Health System, ensuring that all enrollment and credentialing processes and procedures are completed in accordance to applicable regulatory and policy requirements. Identifies provider enrollment issues with the external Provider Enrollment vendor and the internal Provider Enrollment team and utilizes a variety of proprietary and external tools in order to research and resolve.

Core Responsibilities and Essential Functions:

• Coordinates the acquisition and receipt of all enrollment documentation from new and existing providers; provides follow-up and problem resolution as needed.
• Coordinates the processing, distribution, and management of all hospital credentialing and Medical Associates enrollment documents for providers.
• Acts as primary point of contact for all internal and external constituencies in all day-to-day administrative matters associated with the credentialing/enrollment process; troubleshoots and resolves problems and issues as they arise.
• Cross trains with other team members to have a general understanding of Provider Enrollment denial management.
• Develops and maintains a comprehensive credentialing database and prepares reports, rosters and summaries as appropriate; manages physician profiles.
• Develops and implements systems and procedures to ensure that all enrollment processes are completed in accordance to relevant regulation, policies, and standards.
• Maintains and ensures strict confidentiality of files and databases.
• Performs other duties as assigned Complies with all Wellstar Health System policies, standards of work, and code of conduct.

Required Minimum Education:

High School Diploma / GED General or Associates General-Preferred

Required Minimum License(s) and Certification(s):

All certifications are required upon hire unless otherwise stated.

Additional License(s) and Certification(s):

Required Minimum Experience:

Minimum 1 year Enrollment; credentialing/privileging providers; or revenue cycle in a healthcare setting. Required or Minimum 4 years MD Staff relations; credentialing/privileging providers; provider enrollment; revenue cycle. Preferred

Required Minimum Skills:

Excellent verbal and written communication skills. Skilled in the use of personal computers, related software applications, MS Excel and MS Word. Strong interpersonal, organizational, and critical thinking skills. High Experience with MD Staff- Preferred Low

Join us and discover the support to do more meaningful work—and enjoy a more rewarding life. Connect with the most integrated health system in Georgia, and start a future that gives you more.