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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.
Requirements, Preferences and Experience
Education
Preferred: Medical Billing and Coding Diploma from an accredited facility.
Minimum: High School/GED
Experience
Minimum: 2 years focused credentialing experience in a medical billing organization.
Special Skills
Preferred: Working knowledge of CAQH, AMA, NPDB, and primary data source verification. Specific knowledge of payer enrollment application process.
Minimum: Excellent skills in verbal and written communication.
Training
Minimum: Proficient in Microsoft Office. Ability to type 35 wpm
About Baptist Memorial Health Care
At Baptist, we owe our success to our colleagues, who have both technical expertise and a compassionate attitude. Every day they carry out Christ's three-fold ministry-healing, preaching and teaching. And, we reward their efforts with compensation and benefits packages that are highly competitive in the Mid-South health care community. For two consecutive years, Baptist has won a Best in Benefits award for offering the best benefit plans compared with their peer groups. Winners are chosen based on plan designs, premiums and the results of a Benefits Benchmarking Survey.
At Baptist, We Offer:
Competitive salaries
Paid vacation/time off
Continuing education opportunities
Generous retirement plan
Health insurance, including dental and vision
Sick leave
Service awards
Free parking
Short-term disability
Life insurance
Health care and dependent care spending accounts
Education assistance/continuing education
Employee referral program
Job Summary:
Position: 5347 - Specialist-Payer Enrollment
Facility: BMG - Central Business Office
Department: MG CBO Credentialing
Category: Finance and Accounting
Type: Non Clinical
Work Type: Full Time
Work Schedule: Days
Location: US:TN:Memphis
Located in the Memphis metro area REQNUMBER: 23894