Provider Services Specialist

Duties: The Provider Services Specialist is responsible for the timely accurate and compliant enrollment of Atrium Health providers with government payers as well as the timely and accurate processing follow up and verification of completion of applications for participation in Medicare (NC/SC) NC Medicaid (NCTracks) SC Medicaid programs for AH providers and physician groups. The position is responsible for ensuring that the credentialing and enrollment functions are completed in compliance with all Atrium Health CMS State and national accrediting agency(s) standards.

Skills: ESSENTIAL FUNCTIONS: Independently processes and submits complete timely and accurate enrollment applications to The Center for Medicare Services (CMS) and state Medicaid offices on behalf of new groups and currently employed Atrium Health Medical Group (AHMG) providers and groups billing under AH MG tax ID numbers. Resolves issues and supports Practice Leadership / Practice Manager regarding provider enrollment and credentialing for AHMG Affiliates and the Professional Billing Office. Regularly follows up of status of submitted applications and provider maintenance requests with CMS and state Medicaid offices and communicates status updates to all constituents via MOAD or other tracking system and email. Demonstrates the ability to communicate professionally and clearly in both verbal and written form to physicians corporate staff external agencies and government / managed careorganizations. Accurately and clearly documents process steps dates and work status in the MOAD system. Answers departmental telephone and emails routes to appropriate staff and takes accurate messages as needed. Commits to return all phone and email inquiries within 24 hours even if not resolved. Manages time prioritizes assignments and coordinates functions effectively to meet the departmental goals and quality standards. Maintains confidentiality of all information related to credentialing and recredentialing. Promotes and assists in the smooth efficient delivery of departmental services to providers AH MG AH and other corporate departments and outside agencies. Performs other duties and responsibilities as assigned with minimal supervision and within timeframe specified. Participates in performance improvement activities. Collaborates effectively with all personnel within the department and throughout AtriumHealth.

Education: High School diploma required. College bachelor s degree preferred. 3 years experience in a role that performs or supports provider enrollment or similar operations in a hospital or managed care environment is required. Certification through National Association of Medical Staff Services (NAMSS) as Certified Provider Credential Specialist (CPCS) or Professional Medical Services Management (CPMSM) preferred. Experience with primary source verifications Medicare North & South Carolina Medicaid NCQA and DOI standards is preferred.

Schedule Notes: Interview or Auto Offer: Auto Offer Local Contract Length: 13 Weeks Location: 4435 GOLF ACRES DRIVE m Charlotte NC (Onsite) Specialty/Unit: Schedule: MF 8a5P Weekend/Float Requirements (if applicable): Opportunity for weekend OT Certification/Licensure/Experience Requirements: Must have HS Diploma Experience in hospital or managed care setting Strong computer skills (Excel). Certification/Licensure/Experience Preferences: Medical Clerical Background Experience in HR Submittal Packet Requirements: Cover Page Resume Proof of Required Certifications/Licensure Important Notes (If Applicable):
Required Skills: MANAGED CARECPCSMEDICAREBILLINGCMS
Additional Skills: MAINTENANCEMEDICAIDOPERATIONSCONTENT MANAGEMENT SYSTEM

Hours Per Day: 8.00
Hours Per Week: 40.00
Languages: English( Speak Read Write )
Department: 41153 : Government Enrollment Atrium Health Corporate Allocated : CORPORATE
Job Category: NonClinical Onsite