<p>The Provider Enrollment Specialist is responsible for requesting contracts and participation for providers in and with health plans to minimize the possibility of delay or non-payment of claims for services rendered by practitioners. LBMC Physician Business Solutions' main office is located in Brentwood, Tennessee, but this position is remote.</p> <p>ESSENTIAL FUNCTIONS:</p> <p>To perform this job, an individual must perform each essential function satisfactorily with or without a reasonable accommodation:</p> <ul> <li>Complete accurately CAQH credentialing process on new providers or groups. </li><li>Follow-up with payers for effective dates, and status updates on a regular basis. </li><li>Responsible for completing applications, re-credentialing applications, demographic updates, and documents to each payer for processing. </li><li>Research payers for information on processes to enroll providers/groups, contact representative information, and status of provider/group already in the system or not. </li><li>Candidate must be able to request a payor contract on behalf of a client. </li><li>Update and maintain CAQH database with all current provider information that is received from the client as well as updated licenses, DEA and add locations to the provider/group. </li><li>Monitor CAQH for expiring documents (i.e., license, DEA) and proactively contact client for updated information when required. </li><li>Monitor and maintain provider files to determine reason for pending enrollment and/or acknowledge all documents are received; request any documents and usernames/passwords needed for enrollments; routinely update status changes. </li><li>Perform routine administrative tasks to include but not limited to, processing applications, uploading and updated documents, notification forms, enroll provider(s) with all designated payers, and research process with payer in a timely manner. </li><li>Research payer enrollment questions and issues raised by clients and respond with resolution. </li><li>Complete and follow-up on Hospital re-appointment applications as requested by practice. </li></ul> <p>REQUIREMENTS:</p> <ul> <li>Candidate must have 5 years of payor contracting/ payor enrollment experience in a fast-paced independent environment handling multiple tasks for multiple clients. </li><li>Candidate must be proficient in Microsoft Office products </li><li>Candidate must be able to work independently on projects and communicate project status to supervisor and client in a professional manner. </li><li>Experience with credentialing software a plus. </li></ul>