Job Information
Arkansas Children's Provider Enrollment Specialist in Little Rock, Arkansas
Work Shift:
Day Shift
Time Type:
Full time
Department:
CC017090 Patient Financial Services
Summary:
Monday - Friday, 8:00 a.m. - 5:00 p.m. ▬ Hybrid
The Provider Enrollment Specialist facilitates the applications from a new/existing provider’s through all stages in order to enroll or re-validate the provider’s with commercial and/or government payers as well as facilities. The Specialist is also responsible for updating practitioner information in both the internal software and with external payers. In addition to data entry, the specialist also maintains copies of licensure, certificates, and other documents necessary for the enrollment process, maintains provider CAQH profiles, and conducts verification of all data, ensuring accuracy and timely entry of information. The specialist shares essential updates with providers and the internal team as necessary in weekly summary reports. Decisions will have a direct impact upon the efficiency and effectiveness of Enrollment and upon direct staff. Decisions also have the potential to impact PHO rosters, COM departments and Billing Services. Must function fairly independently with a strong awareness of the interactions and interdependency of all areas
Additional Information:
Experience Requirements:
• Strong communication skills as you will be speaking with payers, facilities, medical billing staff, and/or clients weekly via telephone
• Knowledge of medical credentialing and privileging procedures and standards
• Willingness to establish and maintain effective work relationships with providers, payers, MSOs, co-workers, supervisors, and/or managers
• Ability to analyze, interpret, and draw inferences from research findings and prepare reports
• Ability to work independently in a fast-paced environment while remaining calm and professional
• Database management skills, including querying, reporting, and document generation
• Must be able to multi-task
• Excellent organizational skills and must be detail-oriented
• Proficiency in Microsoft Office
• Strong computer and typing skills
• Positive, friendly, approachable disposition
• Ability to work with multiple priorities
Required Education:
Bachelor's degree from four-year college or university; Or four years related experience and/or training; or equivalent combination of education and experience.
Recommended Education:
Bachelors Degree or Equivalent Experience
Required Work Experience:
Recommended Work Experience:
Related Field - Previous experience in a health care setting
Required Certifications:
Recommended Certifications:
Description
1.Conducts the enrollment process and maintains provider information in MD Staff platform
Adheres to deadlines and enrollment schedules by tracking files through all stages
Communicates with providers, payers, MSOs via email, phone, Teams and mail
Helps the department move to paperless by centralizing all provider data gathered in software
Maintains confidentiality and responsibility for all enrollment files through the process
Maintain an organized database of physician information, ensuring accuracy and completeness.
Ensure that all enrollment activities adhere to healthcare regulations and organizational policies.
Collaborate with internal departments, including HR, legal, and billing, to facilitate the enrollment process.
Address and resolve enrollment-related issues and discrepancies promptly. Monitor and meet goals established for KPI metrics
Generate reports and documentation related to physician enrollment, as needed. Maintaining work ques for provider enrollment within HIS system.
Other duties as assigned.
Arkansas Children’s (https://www.archildrens.org/about-us) is the only hospital system in the state dedicated to caring for children, which enables us to uniquely shape the landscape of pediatric care in Arkansas.
Arkansas Children’s is driven by four core values—safety, teamwork, compassion and excellence—which inform every action.
Arkansas Children’s Hospital has received Magnet Status (https://www.archildrens.org/about-us/magnet-recognition) from the American Nurses Credentialing Center (ANCC), for nursing excellence and patient outcomes. And we are nationally ranked by U.S. News & World Report (https://www.archildrens.org/about-us/awards-and-recognition) for Cancer, Cardiology & Heart Surgery, Diabetes & Endocrinology, Nephrology, Neurology & Neurosurgery, Pulmonology & Lung Surgery and Urology.
For more than a century, Arkansas Children’s has met the unique needs of children. But we’re more than just a hospital treating sick kids—our services include two hospitals, a pediatric research institute, foundation, clinics, education and outreach, all with an unyielding commitment to making children better today and healthier tomorrow.
Arkansas Children’s Little Rock campus includes a 336-bed hospital with the state’s only pediatric Level 1 Trauma Center, burn center, Level 4 neonatal intensive care and pediatric intensive care, as well as a nationally-recognized transport service. And Arkansas Children’s Northwest (https://www.archildrens.org/locations/arkansas-childrens-nw) provides inpatient and emergency care, clinic rooms and diagnostic services to children in that corner of the state.
“Arkansas Children’s is a place of hope and comfort for children and parents. When you are at children’s, you are part of an elite team united with a common goal of saving children and making their lives better.” Michael – Business Operations Manager
“Arkansas Children’s Hospital is a prestigious institution that cares for children.” Linda – Information Systems Analyst
“We are an organization of care, love, and hope while we champion children.” Angela – Parking and Fleet Coordinator
“Care, love, and hope for children!” Kathy – Administrative Assistant
“When I think of my time here at Arkansas Children’s Hospital, I can honestly say that it has given me a unique perspective on the human condition, and the various roles that we all have in patient care. As a supply assistant, I have a very important job ensuring that the doctors and nurses have what they need to provide the world class medical care to the Children of Arkansas and surrounding states. Being a Champion for Children is more than a catch phrase, it is a way of life!” Nick – Supply Assistant
Arkansas Children's provides equal employment opportunity to all persons without regard to age, race, color, religion, national origin or citizenship status, disability, military status, sexual orientation, gender identity or expression, pregnancy or any other category protected by federal, state and local laws. Further, Arkansas Children's will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant.