Offer summary

Qualifications:

High School Diploma or GED required; Associate's degree preferred., Minimum of 1 year experience in enrollment, credentialing, or revenue cycle in a healthcare setting., Preferred experience includes 4 years in MD staff relations or provider enrollment., Strong problem-solving skills and ability to manage confidential information..

Key responsabilities:

Coordinate the acquisition and management of enrollment documentation for providers.

Act as the primary contact for administrative matters related to the credentialing/enrollment process.

Develop and maintain a comprehensive credentialing database and prepare necessary reports.

Implement systems to ensure compliance with regulations and maintain confidentiality of files.

Job description

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.

Job Summary:

Coordinates and administers the enrollment process for medical providers on behalf of practice plan and Wellstar MCG Health System, ensuring that all enrollment and credentialing processes and procedures are completed in accordance to applicable regulatory and policy requirements. Identifies provider enrollment issues with the external Provider Enrollment vendor and the internal Provider Enrollment team and utilizes a variety of proprietary and external tools in order to research and resolve.

Core Responsibilities and Essential Functions:

Coordinates the acquisition and receipt of all enrollment documentation from new and existing providers;
provides follow-up and problem resolution as needed. Coordinates the processing, distribution, and
management of all hospital credentialing and Medical Associates enrollment documents for providers. 35%
Acts as primary point of contact for all internal and external constituencies in all day-to-day administrative
matters associated with the credentialing/enrollment process; troubleshoots and resolves problems and
issues as they arise. Cross trains with other team members to have a general understanding of Provider
Enrollment denial management. 35%
Develops and maintains a comprehensive credentialing database and prepares reports, rosters and
summaries as appropriate; manages physician profiles. 15%
Develops and implements systems and procedures to ensure that all enrollment processes are completed in
accordance to relevant regulation, policies, and standards. Maintains and ensures strict confidentiality of
files and databases. 15%

Required Minimum Education:

High School Diploma General Required and GED General Required or
Associates General Preferred (or)

Minimum 1 year Enrollment; credentialing/privileging providers; or revenue cycle in a healthcare setting. Required

Required Minimum Experience:

Minimum 1 year Enrollment; credentialing/privileging providers; or revenue cycle in a healthcare setting. Required
Minimum 4 years MD Staff relations; credentialing/privileging providers; provider enrollment; revenue cycle. Preferred

Join us and discover the support to do more meaningful work—and enjoy a more rewarding life. Connect with the most integrated health system in Georgia, and start a future that gives you more.

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