Medicaid Provider Enrollment Specialist

Hourly Wage Estimate: $15.00 - $21.44 / hour

Learn more about the benefits offered (  ) for this job.

The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range.

This Work from Home position requires that you live and will perform the duties of the position; within 60 miles of an HCA Healthcare Hospital (Our hospitals are located in the following states: FL, GA, , KS, KY, MO, NV, NH, NC, SC, TN, TX, UT, VA).

Are you passionate about the patient experience? At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like family! Jump-start your career as a Medicaid Provider Enrollment Specialist today with Parallon.

Seeking a Provider Enrollment Specialist who is responsible for processing enrollments for new and existing individual providers and group practices, such as initiating new enrollments with Commercial and Governmental payors and reporting demographic or other provider changes. Other duties include follow-up on open applications with providers or payors, including escalation to the Provider Enrollment Account Management team or Strategic Pricing and Analytics (SPA) Managed Care Team for resolution.

We are an amazing team that works hard to support each other and are seeking a phenomenal addition like you. We want you to apply today!

• Ensure provider participation with contracted payors by taking appropriate next actions to complete enrollment, such as completing applications, rosters, and notifications
• Monitor inventory
• Escalate items to other areas outside of department as needed
• Work with payors and providers to ensure compliance with enrollment process
• Initiate contact with payors and practices via telephone or electronic methods with respect to provider enrollment and billing errors, utilizing proper customer service protocol
• Update and maintain data in appropriate Provider Enrollment systems while ensuring accuracy and data integrity
• Review correspondence received and perform appropriate action to resolve
• Appropriately resolve or escalate payor application denials
• Meet and maintain established departmental performance metrics for production and quality
• Maintain working knowledge of workflow, systems, and tools used in the department

• 1 year of related experience required, such as Medicare/Medicaid Enrollment or Managed Care Enrollment
• Relevant education may substitute experience requirement
• Knowledge of National Plan and Provider Enumeration System (NPPES) and Council for Affordable Quality Healthcare (CAQH) preferred

• Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
• Wellbeing support, including free counseling and referral services
• Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
• Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
• Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
• Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts

Learn more about Employee Benefits ()

Note:

Eligibility for benefits may vary by location.

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.