Enrollment Specialist Managed Care

Enrollment Specialist AdventHealth Corporate

Location Address: 1051 Winderley Place Suite 400 Maitland, FL 32751

Top Reasons To Work At AdventHealth Corporate

• Great benefits
• Immediate Health Insurance Coverage
• Career growth and advancement potential

• Full-Time, Monday â“ Friday

You Will Be Responsible For:

• Responsible for the credentialing efforts for primary care and/or specialist physician and/or mid-level providers employed by AHS Florida Division physician groups. 
• Responsible for understanding and utilizing the functionality of Apogee (or any subsequent credentialing database) and training new employees. 
• Responsible for programming physician/provider applications within Apogee (or any subsequent credentialing database) and works.to ensure physician/provider information is complete, accurate, and up to date.
• Communicates with physician/provider office staff and practice management regarding the status of applications, additional materials required, etc.
• Educates physician/provider and physician/provider leadership staff on necessary documentation needed in order to credential physician/provider.
• Supports the Credentialing Manager and Director of Credentialing and Revenue Management by resolving problems, questions, and issues internally, as well as at the payer and the practice.
• Coordinates process with Negotiators to ensure contracts are in place prior to sending applications to payer.
• Ability to assess individual credentialing staff member performance and communicates with leadership on needed areas of improvement.
• Acts as provider relationsâ™ representative to physician groups in order to assist with operation and payment issues, as appropriate.

• High school diploma or equivalent
• Minimum of four yearsâ™ experience in healthcare; preferably in managed care, provider credentialing, patient financial services or provider relations
• Typing: 35wpm
• Bachelorâ™s degree in business, healthcare administration or related field, preferred
• Four or more years in healthcare or managed care, preferred

Responsible for physician systems including applications and credentialing for various physician groups and specialties for which contracting services are provided. Maintains and updates all credentialing systems with current information for all physicians/providers.  Responsible for coordinating and maintaining all credentialing documents necessary to complete credentialing and re-credentialing of all physicians/providers for which we contract.  Responsible for auditing and data analysis for all physician/provider credentialing records, documents and files.  Responsible for programming Apogee applications to generate reports necessary to ensure accuracy of physician/provider records.  Actively participates in physician group leadership meetings and is accountable for presenting credentialing status for all groups. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.