Representative Provider Relations I - Business Office - FT - Days - MPG

Location:

Miramar, Florida

At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience.

Summary:

Position is responsible for the Memorial Healthcare Systems Physician Provider Groups, employed physicians and auxiliary personnel, including non-physician health care professionals (Provider) Payer registrations and credentialing.

Responsibilities:

Re-enrollment/re-validation of all providers with Medicare, Medicaid, and Managed Care Plans.Enrolls all new providers with Medicare, Medicaid and all Managed Care Plans.Maintains all physician enrollment documentation and documentation status for all physicians with Medicare, Medicaid, and Managed Care Plans.Provides status reports of plan participation, as necessary.

Competencies:

ACCOUNTABILITY, ACCURACY, ANALYSIS AND DECISION MAKING, CUSTOMER SERVICE, DEVELOPS RELATIONSHIPS, EFFECTIVE COMMUNICATION, PATIENT AND FAMILY CENTERED CARE, RESPONDING TO CHANGE, STANDARDS OF BEHAVIOR, TEAM WORK

Education and Certification Requirements:

High School Diploma or Equivalent (Required)

Additional Job Information:

Complexity of Work: Required critical thinking skills, effective communication skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action. Familiar with CMSs physician and allied health personnel, CAQH healthcare provider data management tool, and PECOS Medicaid provider enrollment system. Required Work Experience: No prior work experience required. Other Information: Healthcare experience and physician insurance credentialing preferred.

Working Conditions and Physical Requirements:

•  Bending and Stooping = 40%
•  Climbing = 0%
•  Keyboard Entry = 60%
•  Kneeling = 0%
•  Lifting/Carrying Patients 35 Pounds or Greater = 0%
•  Lifting or Carrying 0 - 25 lbs Non-Patient = 40%
•  Lifting or Carrying 2501 lbs - 75 lbs Non-Patient = 0%
•  Lifting or Carrying > 75 lbs Non-Patient = 0%
•  Pushing or Pulling 0 - 25 lbs Non-Patient = 40%
•  Pushing or Pulling 26 - 75 lbs Non-Patient = 0%
•  Pushing or Pulling > 75 lbs Non-Patient = 0%
•  Reaching = 60%
•  Repetitive Movement Foot/Leg = 0%
•  Repetitive Movement Hand/Arm = 60%
•  Running = 0%
•  Sitting = 60%
•  Squatting = 0%
•  Standing = 60%
•  Walking = 60%
•  Audible Speech = 60%
•  Hearing Acuity = 60%
•  Smelling Acuity = 0%
•  Taste Discrimination = 0%
•  Depth Perception = 60%
•  Distinguish Color = 60%
•  Seeing - Far = 60%
•  Seeing - Near = 60%
•  Bio hazardous Waste = 0%
•  Biological Hazards - Respiratory = 0%
•  Biological Hazards - Skin or Ingestion = 0%
•  Blood and/or Bodily Fluids = 0%
•  Communicable Diseases and/or Pathogens = 0%
•  Asbestos = 0%
•  Cytotoxic Chemicals = 0%
•  Dust = 0%
•  Gas/Vapors/Fumes = 0%
•  Hazardous Chemicals = 0%
•  Hazardous Medication = 0%
•  Latex = 0%
•  Computer Monitor = 60%
•  Domestic Animals = 0%
•  Extreme Heat/Cold = 0%
•  Fire Risk = 0%
•  Hazardous Noise = 0%
•  Heating Devices = 0%
•  Hypoxia = 0%
•  Laser/High Intensity Lights = 0%
•  Magnetic Fields = 0%
•  Moving Mechanical Parts = 0%
•  Needles/Sharp Objects = 0%
•  Potential Electric Shock = 0%
•  Potential for Physical Assault = 0%
•  Radiation = 0%
•  Sudden Decompression During Flights = 0%
•  Unprotected Heights = 0%
•  Wet or Slippery Surfaces = 0%

Shift:

Disclaimer: This job description is not intended, nor should it be construed to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with the job. It is intended to indicate the general nature and level of work performed by employees within this classification.

Wages shown on independent job boards reflect market averages, not specific to any employer. We encourage candidates to talk to their Memorial Healthcare System recruiter to discuss actual pay rates, during the hiring process.

Memorial Healthcare System is proud to be an equal opportunity employer committed to workplace diversity.

Memorial Healthcare System recruits, hires and promotes qualified candidates for employment