Community Health Systems Provider Enrollment Manager in Brentwood, Tennessee

Description:

The Provider Enrollment Manager is responsible for thecompletion of provider applications and follow up for Quorum Health s newlyacquired and existing entities for all governmental payers and obtaining thenecessary information and signatures. This position will communicate to management all changes in enrollmentrequirements.

DUTIES AND RESPONSIBILITIES:

  • Complete CMS 855 applications and EFT for all newacquisitions and current Quorum Health facilities.Submit all paperwork/applications to the MAC/FI and follow through untilTIE in Notice is received and setup is completed with MAC/FI.

  • Complete 855 applications and EFT for change of informationor DPU additions/deletions and follow through until completion with the MAC/FIand CMS. Attend weekly conference calls in preparation for any new enrollmentsfor hospital acquisitions or departments of the hospital.

  • Complete Medicaid and Governmental applications necessaryfor new acquisitions or new provider numbers as needed.Follow through until processing is complete,a provider numbers has been attained and the payer is set up for billing.

  • Assist facilities in completing out of state Medicaidapplications and other HMO/PPO applications as needed.

  • Apply for any NPI numbers needed for new acquisitions or DPUadditions and relate these back to the facility in order for them to append forbilling purposes.

  • Build relationships with payor provider enrollmentdepartments to assist in facilitating enrollment

  • Complete Medicare/Medicaid status chart monthly in order toupdate upper management on status of applications.

  • Act as the liaison for all Quorum Health facilities withMedicare enrollment department to work with them as needed and resolve anyissues.Update facilities and otherQuorum Health departments on application status as needed.

  • Complete re-validation as required by CMS for allfacilities, including their subparts, HHAs, Hospices and other entities.

  • Any other assigned PFS responsibilities as requested by theVP of PFS not specifically noted above which may include working with the SSCson AR projects or assignments.

  • Complete PECOS, Illinois Impact and CAGE code enrollment forfacilities.

  • Complete enrollment changes for any hospital divestiturerequests.

  • Maintain files and database to ensure documents andinformation are current and meet all regulatory and contractual requirements.

  • Research and document credentialing and enrollmentrequirements for all health plans.

  • Maintain confidentiality at all times in accordance withHIPAA guidelines.

Qualifications

KNOWLEDGE, SKILLS AND ABILITIES:

  • Proficient in MS Word and MS Excel.

  • Excellent written and verbal communications.

  • Excellent organizational skills required.

  • Must have good independent thought and judgement.

  • Must be detail oriented and possess strong time managementskills

.

WORK EXPERIENCE, EDUCATION AND CERTIFICATIONS:

BS/BA preferred in a related field or relevant experience isdesired.

Minimum of 2 years of experience in a healthcare settingpreferred.

TRAVEL REQUIREMENTS:

Minimal.

Job: Corporate Positions

Organization:

Location: TN-Brentwood

Requisition ID: 1821370