Facility: Wellstar MCG Health, Inc.

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:

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