Provider Enrollment Specialist - Phoebe Physicians Group

Description

JOB SUMMARY
  • Assures medical providers are enrolled in third party and government contracts and serves as liaison between Phoebe Physician Group Inc, (PPG),payors, Physicians and billing personnel. Provides efficient and centralized enrollment for PPG providers and PPMH hospital providers of pro-fee services. Serves as a resource for internal and external customers regarding enrollment procedures. Works closely with PPG Physician recruiters to ensure enrollment packages are updated and distributed to Physicians prior to start date. Prepares and submits provider enrollment applications to ensure the capability of billing services in a timely and accurate manner. Acts as a liaison between MSO and newly acquired medical practices joining PPG, Inc. Assists MSO Educator in performance of audits of Physician's medical practices. Resolves provider enrollment problems associated with outstanding claim-denial issue.
GENERAL REQUIREMENTS
  • Adheres to the hospital and departmental attendance and punctuality guidelines
  • Performs all job responsibilities in alignment with the core values, mission and vision of the organization
  • Performs other duties as required and completes all job functions as per departmental policies and procedures
  • Maintains current knowledge in present areas of responsibility (i.e., self education, attends ongoing educational programs)
  • Attends staff meetings and completes mandatory in-services and requirements and competency evaluations on time.
WORKING CONDITIONS
  • General environment: Works in a well-lighted, air-conditioned area, with moderate noise levels.
  • Periods of high stress and fluctuating workloads may occur.
  • May be scheduled as needed including overtime


Qualifications

EDUCATION REQUIREMENTS
  • High School Diploma
EXPERIENCE REQUIREMENTS
  • 2 - 3 years Billing, registration and/or collections in a medical practice (Required)
  • 0 - 1 year preparation and monitoring of provider enrollment applications for new providers (Preferred)
  • 0 - 1 year Mentoring/training new staff on a practice management system (Preferred)
CERTIFICATIONS AND LICENSURES
  • Preferred Certifications/Licensures: Certified Patient Account Representative (CPAR)
GENERAL SKILLS
  • Organizational Skills
  • Communication Skills
  • Interpersonal Skills
  • Customer Relations
  • Grammar / Spelling
  • Read / Comprehend Written Instructions
  • Follow Verbal Instructions
  • Basic Computer Skills
  • Microsoft Office Suite
  • General Clerical Skills
PHYSICAL REQUIREMENTS
  • Have near normal vision - Clarity of vision (both near and far), ability to distinguish colors
  • Have good - manual dexterity
PHYSICAL DEMANDS
  • Standing - Occasionally within shift (1-33%)
  • Walking - Occasionally within shift (1-33%)
  • Sitting - Continuously within shift (67-100%)
  • Climbing - Occasionally within shift (1-33%)
  • Bending/Stooping - Occasionally within shift (1-33%)
  • Twist at waist - Occasionally within shift (1-33%)
  • Pushing/Pulling - Occasionally within shift (1-33%)
  • Lift/carry up to 20 lbs - Occasionally within shift (1-33%)
  • Lift/carry > 20 lbs with assistance - Occasionally within shift (1-33%)
  • Reaching above shoulder - Occasionally within shift (1-33%)