Provider Enrollment Manager

TeamHealth is named among the Top 150 Places to Work in Healthcare by Becker's Hospital Review. Newsweek Magazine recognizes TeamHealth as ‘one of the greatest workplaces for diversity, 2024’ and TeamHealth is also ranked as ‘The World’s Most Admired Companies’ by Fortune Magazine. TeamHealth, an established healthcare organization is physician-led and patient focused. We continue to grow across the U.S. from our Clinicians to Corporate Employees. Join us.
What we Offer:
Career Growth Opportunities
Benefit Eligibility (Medical/Dental/Vision/Life) the first of the month following 30 days of employment
401K (Discretionary matching funds available)
Generous PTO
8 Paid Holidays
Equipment Provided for Remote Roles

JOB DESCRIPTION OVERVIEW:

The Provider Enrollment Manager has overall responsibility to assists with planning, organizing, and direct provider enrollment activities as assigned by Provider Enrollment Director and Chief Financial Officer.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Ensures that all assigned Billing Groups and Providers are in compliance with rules and regulations regarding the application for, obtaining and system maintenance of provider numbers for various carriers.
• Manages information maintenance of provider numbers, National Provider Identifier (NPI), requirements of third party carriers for provider numbers, and conveys necessary information on a timely basis to the corporate PETF and Billing Center management staff.
• Manages maintenance of physician files in the billing system, specifically additions, deletions, and changes pertaining to physicians and other pertinent information. This includes a monthly review of group memberships.
• Directs the Provider Enrollment Assistant and Provider Enrollment Reps I & II on the proper procedures regarding the conduct of provider enrollment activities, manages day-to-day workflow and productivity.
• Assists with training new staffs, leads, and motivates staff.
• Possesses a thorough understanding of and maintains all aspects of the applications used, including Team Works and IDX AES.
• Interrelates with Recruiters, Credential Coordinators, VP of Physician Services, and VP of Operations to facilitate the provider application process, outstanding billing applications, credentials, and NPI.
• Reports to Provider Enrollment Director and division on issues that can enhance provider enrollment and on problem physicians and carriers.
• Manages Denial Management System (DMS) workflow for the department to ensure Provider Enrollment Reps I & II are completing by the suggested deadline.
• Assists with Supervising the maintenance of source document files for each state in which TeamHealth has contracts or otherwise performs medical billing. The source document file consists of applications utilized in the provider enrollment process.
• Acts as liaison with the Division Physician Services Group and VP of Operations to obtain current information on all new physicians and changes in the group.
• Provides education to the management staff, Medical Director’s, Provider Enrollment Assistant, and Provider Enrollment Representatives I & II pertaining to changes in provider enrollment rules and regulations.
• Manages the overall day-to-day workflow and communicates with the Provider Enrollment Director on issues or obstacles inhibiting performance.
• Produce the Provider Hold Report weekly and distributes to management staff and Billing Centers.
• Produce Outstanding Billing Applications report to identify issues.
• Assists with Measuring Provider Enrollment productivity by meeting with staff monthly to discuss issues.

Job Requirements: