Provider Enrollment Specialist - Remote

Memorial Physician Practices; Brentwood (TN); Remote; USD 40,000 - 80,000; Full time

Job summary

An established industry player in healthcare is seeking a Provider Enrollment Specialist to enhance its healthcare delivery network. In this vital role, you will manage the enrollment process for healthcare providers, ensuring timely participation with health plans and minimizing delays in claims processing. Your responsibilities will include completing credentialing applications, maintaining provider records, and liaising with payers to resolve enrollment issues. This position offers the opportunity to be part of a dedicated team focused on making communities healthier, while enjoying a comprehensive benefits package that supports your well-being and professional growth.

Benefits

401k

Flexible PTO

Medical Insurance

Dental Insurance

Vision Insurance

Tuition Reimbursement

Employee Assistance Program

Qualifications

• 2+ years of experience in insurance payer background and/or enrollment preferred.
• High school diploma or equivalent required.

Responsibilities

• Complete CAQH credentialing process for new providers.
• Follow up with payers for effective dates and status updates.
• Maintain updated provider files and monitor enrollment status.

Skills

Insurance Payer Background

Provider Enrollment

Administrative Skills

Research Skills

Education

High School Diploma or Equivalent

Tools

CAQH Database

Job description

Provider Enrollment Specialist

Who we are:

At Lifepoint Health, we provide quality healthcare to rural communities. As a valued member of our team, you will be an integral part of a group working together to elevate Lifepoint's healthcare delivery network. Our network includes 60+ community hospitals, 60+ rehabilitation/behavioral health hospitals, and 250 additional sites of care across the United States. As an organization, we are dedicated to serving communities nationwide by providing exceptional care. We believe in the power of our talented teams and strive to create environments where employees find purpose and fulfillment.

What you’ll do:

The Provider Enrollment Specialist is responsible for requesting participation for providers in and with health plans to minimize the possibility of delay or non-payment of claims for services rendered by practitioners.

Responsibilities:

• Complete Council for Affordable Quality Healthcare, Inc. (CAQH) credentialing process on new providers.
• Follow-up with payers for effective dates, status updates, and identification numbers for provider payment and claims to be released.
• Responsible for completing applications, re-credentialing applications, demographic updates and documents to each payer for processing.
• Research payers for information on processes to enroll providers, contact representative information; and status of provider already in the system or not.
• Update, monitor, and maintain CAQH database with all current provider information that is received from the Market Director.
• Input and/or maintain data for provider to include but not limited to, initial input of provider demographics, personal, medical documentation, effective dates, and comments.
• Maintain updated licenses, add locations and various groups.
• Monitor and maintain provider files to determine reason for pending enrollment and/or acknowledge all documents are received; request any documents and user-names/passwords needed for enrollments; routinely update status changes.
• Perform routine administrative tasks to include but not limited to, processing applications, uploading and updated documents, notification forms, enroll provider(s) with all designated payers, and research process with payer in a timely manner.
• Communicate and provide updates to designated market contacts. Research payer enrollment questions and issues raised by market representative and/or providers and respond with resolution.
• Maintain regular and reliable attendance.
• Perform other duties as assigned.

What you’ll need:

Education: High school diploma or equivalent, or combination of education and experience required for the job.

Experience: 2+ years of experience in Insurance Payer Background and/or Enrollment (preferred).

Why choose us:

As a team member of the Health Support Center, our goal is to support those that are in our facilities who are interfacing and providing care to our patients and community members. Our focus is to attract, retain, and empower a diverse and determined workforce. Our mission statement is at the heart of who we are and what we do: “Making Communities Healthier.” In this shared mission, we believe that our collective efforts will shape a healthier future for the communities we serve.

Benefits: We offer an excellent total compensation package, including a competitive salary and benefits. Some of our benefits include 401k, flexible PTO, generous Employee illness benefit (EIB), medical, dental, vision, tuition reimbursement, and an Employee Assistance Program. We believe that happy, healthy people have a passionate engagement with life and work and have designed our package to enhance your wellbeing.

Equal opportunity and affirmative action employers are looking for diversity in candidates for employment: Minority/Female/Disabled/Protected Veteran.