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Provider Enrollment Credentialing Specialist
- HCA Healthcare (Nashville, TN)
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Description
Introduction
Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a Provider Enrollment Credentialing Specialist with Parallon you can be a part of an organization that is devoted to giving back!
Benefits
Parallon offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:
+ Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
+ Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
+ Free counseling services and resources for emotional, physical and financial wellbeing
+ 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
+ Employee Stock Purchase Plan with 10% off HCA Healthcare stock
+ Family support through fertility and family building benefits with Progyny and adoption assistance.
+ Referral services for child, elder and pet care, home and auto repair, event planning and more
+ Consumer discounts through Abenity and Consumer Discounts
+ Retirement readiness, rollover assistance services and preferred banking partnerships
+ Education assistance (tuition, student loan, certification support, dependent scholarships)
+ Colleague recognition program
+ Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
+ Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.
Learn more about Employee Benefits (https://careers.hcahealthcare.com/pages/employee-benefits-and-rewards)
_Note: Eligibility for benefits may vary by location._
Would you like to unlock your potential with a leading healthcare provider dedicated to the growth and development of our colleagues? Join the Parallon family! We will give you the tools and resources you need to succeed in our organization. We are looking for an enthusiastic Provider Enrollment Credentialing Specialist to help us reach our goals. Unlock your potential!
Job Summary and Qualifications
Seeking a Provider Enrollment Credentialing Specialist, who is responsible for processing credentialing files and enrollments for new and existing individual providers and group practices, such as initiating new enrollments with Commercial and Governmental payors and reporting demographic or other provider changes. We are an amazing team that works hard to support each other and are seeking a phenomenal addition like you. We want you to apply today!
W** **hat you will do in this role:
+ Ensure provider participation with contracted payors by taking appropriate actions to complete enrollment, such as completing applications, rosters, and notifications
+ Work with payors and providers to ensure compliance with enrollment process
+ Initiate contact with payors and practices via telephone or electronic methods with respect to provider enrollment and billing errors, utilizing proper customer service protocol
+ Prepare credentialing files for presentation to the Credentialing Committee or the Chief Medical Officer (CMO)
+ Confirm completeness and accuracy of credentialing files prior to committee presentation
+ Work closely with Provider Enrollment Manager to resolve credentialing file issues
+ Ensure payor requirements for submission of rosters are met
+ Monitor inventory, including provisional, credentialing, and recredentialing for all providers as well as expirables to meet payor requirements
+ Assist during payor-delegated credentialing audits
+ Escalate items to other areas outside of department as needed
+ Update and maintain data in appropriate Provider Enrollment systems while ensuring accuracy and data integrity
+ Review correspondence received and perform appropriate action to resolve
+ Appropriately resolve or escalate payor application denials
+ Meet and maintain established departmental performance metrics for production and quality
What qualifications you will need:
+ Minimum of 1 year related healthcare experience preferred, such as Medicare/Medicaid
+ Enrollment or Managed Care Enrollment; relevant education may substitute experience requirement
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**Parallon** provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities.
HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.
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"There is so much good to do in the world and so many different ways to do it."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder
Be a part of an organization that invests in you! We are reviewing applications for our Provider Enrollment Credentialing Specialist opening. Qualified candidates will be contacted for interviews. Submit your application and help us raise the bar in patient care!
We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
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Provider Enrollment Credentialing Specialist
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