The Provider Enrollment Specialist is responsible for the production aspects of the client-focused revenue cycle operations and must display in-depth knowledge of and execute all standard operating procedures (SOPs) as well as communicating issues, trends, concerns and suggestions to leadership.
Processes provider applications and re-applications; including the initial mailing, review and loading.
Processes credentialing and re-credentialing applications of health care providers and assist in the implementation of related procedures and activities.
Reviews applications, prepares verification letters and maintains database and provider profiling system.
Communicates with providers, medical office staff, licensing agencies, and insurance carriers to provide status information and complete credentialing and re-credentialing applications.
In-depth working knowledge of the various applications associated with the workflows.
Ensure all workflow items are completed within the set turn-around-time within quality expectations.
Responds to escalated issues by resolving or redirecting internally.
Performs other duties as assigned.
High School graduate or the equivalent minimum experience required.
Healthcare and revenue service center preferred.
Communicates effectively with all internal and external clients, including managers, employees, vendors, support staff and visitors.
Uses good judgment and critical thinking skills; ability to identify and resolve problems.
Proficient in MS Office software; particularly Excel and Outlook.
Efficient and accurate keyboard/typing skills.
Possess a strong work ethic and a high level of professionalism with a commitment to client/patient satisfaction.
Functional knowledge of HIPAA rules and regulations and experience related to privacy laws, access and release of information.
We reveal and foster God's healing love by improving the health of the people and communities we serve, especially those who are poor and vulnerable.
Inspired by our faith,
•We will be distinguished as the premier person-centered health system and trusted partner.
•We will share accountability with clinicians and other stakeholders to coordinate care across all settin...gs and improve access, quality, health outcomes, and affordability.
•We will grow as community-based health networks to serve more people in partnerships with others who share our vision and values.
Caring Spirit - We honor the sacred dignity of each person.
Excellence - We set and surpass high standards.
Good Humor - We create joyful and welcoming environments.
Integrity - We do the right thing with openness and pride.
Safety - We deliver care that seeks to eliminate all harm for patients and associates.
Stewardship - We are accountable for the resources entrusted to us.