Job Summary:

Team Lead of Provider Enrollment will be responsible and accountable for specialized provider enrollment, as well as operational tasks for Provider Enrollment across all Zones/Regions. This includes but is not limited to the processing of specialized provider enrollment processes including Implementation of new business, pain management, data integrity, auditing, and training for the entire team. Other responsibilities include oversight of all provider enrollment-related activities associated within the zone/region that they are assigned to as well as operational functions for the team, coaching and mentoring and special projects as assigned.

Team lead of Provider Enrollment will have skills and knowledge in problem-solving, credentialing software, reporting, data integrity, data analysis, and project management. Apply key skills and knowledge to ensure that all providers meet payor enrollment requirements within specified time frames.

Duties & Responsibilities:

Provide support and training as required • Management and maintenance of overarching tasks that support the team as a whole • Understand regulations and requirements of payors in the area that they cover to understand

Provide support and training as required • Management and maintenance of overarching tasks that support the team as a whole • Understand regulations and requirements of payors in the area that they cover to understand the needs to be met for specific provider enrollment credentialing • Ensure CAQH, Facility, Payer, Implementation, Client Services & other regulatory requirements for provider enrollment credentialing are adhered to. • Handling incoming requests from physicians, payors, and other agencies • Oversee the completion of various applications & verify integrity of data • Assist with the development and maintenance of departmental policies and procedures. • Oversee any sub delegated processes • Assist internal departments by resolving payment and denial issues as it relates to credentialing. • Facilitate and attend meetings and seminars as required. • Produce weekly and monthly productivity and issues report to management as requested. • Other duties and responsibilities as needed.

Qualifications:

Bachelor’s degree preferred; equivalent experience accepted • Professional business sense and leadership skills • Ability to make sound decisions with limited supervision • Ability to create and nurture a positive and productive work environment • Proficiency in positively motivating staff to highest the potential • Strong communication and follow up skills • Ability to communicate in a clear, concise and transparent manner to staff and management • Aptitude for escalating appropriate issues and problems early in the process • Ability to work independently or in a group setting • Ability to communicate and coordinate with other teams for most efficient, effective and streamlined workflow processes • Strong knowledge of provider credentialing in a physician office, managed care, and hospital setting • Travel as needed.

Total Rewards

• Salary: $23.10 -30.30 per hour
• Generous benefits package, including:
  • Paid Time Off
  • Health, life, vision, dental, disability, and AD&D insurance
  • Flexible Spending Accounts/Health Savings Accounts
  • 401(k)
  • Leadership and professional development opportunities