PPSI
Provider Enrollment Specialist - Remote
,
Full Time
Our Benefits
The Provider Enrollment Specialist ensures healthcare providers are properly credentialed and enrolled with payers, government programs, and healthcare networks. This role facilitates accurate and timely submission of applications, maintains compliance with payer requirements, and updates provider records to ensure the organization can bill for services rendered effectively.
Essential Functions
The PPSI Team and Athena work alongside the Clinic Leaders and staff with the common goal of creating a clean and efficient revenue cycle.
Community Health Systems is one of the nation's leading healthcare providers. With healthcare delivery systems in 36 distinct markets across 14 states, CHS operates 69 affiliated hospitals with more than 10,000 beds and approximately 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, imaging centers, cancer centers, and ambulatory surgery centers.
- Comprehensive Health Coverage: Medical, dental, and vision plans to keep you and your family healthy.
- Competitive Pay & Full Benefits: A salary and package designed to reward your expertise and dedication.
- Paid time off
- Flexible scheduling
- Future Security: 401(k) with matching.
The Provider Enrollment Specialist ensures healthcare providers are properly credentialed and enrolled with payers, government programs, and healthcare networks. This role facilitates accurate and timely submission of applications, maintains compliance with payer requirements, and updates provider records to ensure the organization can bill for services rendered effectively.
Essential Functions
- Prepares, reviews, and submits applications for provider enrollment and re-credentialing with insurance companies, Medicare, Medicaid, and other payers.
- Monitors and tracks enrollment and credentialing statuses, ensuring adherence to deadlines and compliance requirements.
- Updates and maintains accurate provider information in databases, payer systems, and organizational records.
- Communicates with providers, payers, and other stakeholders to resolve enrollment issues and provide updates on application statuses.
- Analyzes payer requirements and ensures applications meet regulatory standards and organizational policies.
- Collaborates with internal teams, including billing and compliance, to address issues impacting revenue cycle management.
- Identifies and implements process improvements to streamline provider enrollment and credentialing workflows.
- Performs other duties as assigned.
- Maintains regular and reliable attendance.
- Complies with all policies and standards.
- This is a fully remote position.
- H.S. Diploma or GED required
- Associate Degree in Healthcare Administration, Business, or a related field preferred
- 2-4 years of experience in provider enrollment, credentialing, or a related role required
- Experience with MD-Staff or other payer enrollment software strongly preferred
- Experience working with healthcare payers, Medicare/Medicaid regulations, and credentialing software preferred
- Strong knowledge of payer enrollment requirements, credentialing standards, and regulatory compliance.
- Proficiency in credentialing software and systems.
- Excellent organizational skills and attention to detail.
- Effective verbal and written communication skills.
- Ability to manage multiple priorities and meet deadlines.
- Certified Provider Credentialing Specialist (CPCS) preferred
The PPSI Team and Athena work alongside the Clinic Leaders and staff with the common goal of creating a clean and efficient revenue cycle.
Community Health Systems is one of the nation's leading healthcare providers. With healthcare delivery systems in 36 distinct markets across 14 states, CHS operates 69 affiliated hospitals with more than 10,000 beds and approximately 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, imaging centers, cancer centers, and ambulatory surgery centers.