Provider Enrollment Intake Rep 2
PPSI - Franklin, TN

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1313992

Description

Summary

:

Assist Provider Enrollment Specialist in various areas of the enrollment process as needed

Essential Duties and Responsibilities:
Include the following

. Other duties may be assigned.

Must have worked in a medical practice

Responsible for intake and tracking of Notification forms and checklist items.

Assist in the enrollment process by data entry of information into Vistar system for initial, updated; add on applications and maintenance processes.

Accurately perform a variety of enrollment duties such as: placing calls, processing incoming correspondence, faxing, scanning, linking documents to appropriate provider file, sending inquires to payers,

copying,

proper documentation of all details in provider file per PE Guidelines

and other duties as needed.

Review new enrollment files for deficiencies.

Pursue incomplete information with practice contact or provider.

Process and maintain re-credentialing applications in accordance with CHS PE policy and procedure.

Assist as needed in preparing enrollment applications.

Update expired fields in Vistar such as license, DEA and malpractice as needed.

Advise Enrollment Specialist of questionable information received and any issues identified during the processes.

Compliance with CHS Enrollment policy and procedure.

Practice and adhere to the "Code of Conduct" per CHS policy.

Initial completion of CAQH applications and update as needed for re-credentialing.

Ensure confidentiality ALL of data.

Supervisory Responsibilities:
This job has no supervisory responsibilities

Competencies:
To perform the job successfully, an individual should demonstrate the following competencies:

Analytical

  • Collects and researches data; Uses intuition and experience to complement data
Customer Service

  • Responds promptly to customer needs
Interpersonal Skills

  • Maintains confidentiality of all patient information and company documents
Oral Communication

  • Listens and gets clarification; Responds well to questions
Written Communication

  • Able to read and interpret written information
Professionalism

  • Approaches others in a tactful manner; Treats others with respect and consideration regardless of their status or position
Quality

  • Demonstrates accuracy and thoroughness
Quantity

  • Meets productivity standards
Adaptability

  • Adapts to changes in the work environment
Attendance/Punctuality

  • Is consistently at work and on time
Qualifications

Qualifications:
Organization - proactively prioritizes needs. Ability to show attention to detail.

Communication - communicates clearly and concisely. Must have excellent interpersonal and written communication skills. This includes spelling and grammar skills.

Customer

Service- establishes and maintains long-term customer relationships

Policies & Procedures - articulates knowledge and understanding of organizational policies, procedures, and systems.

PC Skills - demonstrates proficiency in Microsoft Office (Outlook, Excel, and Word) applications and others as required.

Ability to work independently and under pressure.

Credentialing –Knowledge of credentialing process preferred

Education and Experience Preferred:
High school diploma or general education degree (GED).

At least 1 year previous office experience including data entry, typing, and basic computer usage and proficient keyboard and PC skills preferred. Previous Credentialing experience preferred. Typing speed 30-50 words per minute. Understanding of professional telephone etiquette. Able to work with minimal supervision and works well in both individual and group environment.

Language Skills:
Ability to read and comprehend simple instructions, short correspondence, and memos.

Ability to write simple correspondence.

Ability to effectively present information in one-on-one and small group situations.

Reasoning Ability:
Ability to apply common sense understanding to carry out detailed written or oral instructions.

Ability to deal with problems involving a few concrete variables in standardized situations.

Computer Skills:
To perform this job successfully, an individual must have knowledge of general computer applications and practice management systems.

Physical Demands:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear. The employee is occasionally required to reach with hands and arms and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision and ability to adjust focus.

Job

Business Office Support

Primary Location

TN-Franklin (Nashville Region)

Organization

PPSI

Shift

Day Shift

Forecasted paid hours per shift

8

Forecasted hours per pay week

40

Employee Status

Full-time

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