Specialist-Payer Enrollment Senior – MG CBO Credentialing

Summary

Responsible for the collection and review of credentialing documents to ensure the accuracy of all enrollment applications and re-credentialing documents submitted to payers. Support 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. This includes direct communication with providers, payers, clinic personnel, Operation Directors and Managers and Executive Directors as needed, report generation, data entry, primary data source verification, CAQH attestation, preparation of enrollment documents to be forwarded to the provider and other duties as assigned. Each function requires the highest level of accuracy and confidentiality. Performs all duties as assigned.

Responsibilities

Team Lead essential responsibilities

Maintains current knowledge of credentialing practices and standards.

Completes government and commerical insurance enrollment applications for new and established providers within BMG and BMG Foundations.

Provides exellent service to all customers: patients , providers, payers, clinic staff, Physican Revenue Cycle staff, Operations and Administration.

Maintains current licensure, dea, certifications, board certifications and all other credentialing documents.

Completes assigned goals.

Requirements, Preferences and Experience

Education

Preferred: Associates or Bachelors in Business, Finance, Health Care or related field

Minimum: High school diploma/ GED and relevant combination of education and experience

Experience

Preferred: Supervisory experience desired

Minimum: 2 years focused credentialing experience in a medical professional billing organization.

Special Skills

Preferred: Experience with Symed/ OneApp Pro/ Echo, or similar practitioner credentialing, data collection and record management system

Minimum: 1. Proven effective written and verbal communication skills. 2. Experience with provider enrollment processes, policies and procedures, including delegated credentialing requirements 3. Demonstrated effective analytical skills needed to assess compliance, record, analyze and interpret data into meaningful formats 4. Ability to manage multiple projects efficiently and accurately 5. Demonstrated ability to work independently 6. Demonstrated ability and commitment to excellent customer service to maintain and ensure effective working relationships with internal and external clients 7. Ability to adapt to change and meet deadlines 8. Ability to adapt to change and meet deadlines 9. Demonstrated attention to detail and high degree of accuracy 10. Requires exceptional critical thinking skills, sounds judgment and the ability to communicate in an articulate and sensitive manner with practitioners, administrators, legal counsel and client credentialing personnel

Training

Preferred: Proficient in Visio

Minimum: Proficient in Microsoft Office with a high level of proficiency in Excel 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 Christs 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: 6933 – Specialist-Payer Enrollment Senior

Facility: BMG – Central Business Office

Department: MG CBO Credentialing

Category: Finance and Accounting

Type: Non Clinical

Work Type: PRN

Work Schedule: Days

Location: US:TN:Memphis

Located in the Memphis metro area REQNUMBER: 24927