Provider Solutions Quality Coordinator

Department: Operations
Brentwood, TN

Position Summary

The Provider Solutions Quality Coordinator is responsible for maintaining the integrity and quality of the enrollment process.

Primary Duties and Responsibilities:

  • 20%: Prepping and validating startup roster
  • 15%: Verifying PE information is successfully entered in the Provider Enrollment system
  • 15%: Develop and maintain CAQH daily tracking process
  • 15%: Develop and maintain expirable processes
  • 10%: Develop and maintain revalidation process
  • 10%: Develop and maintain re-credentialing process
  • 5%: Identify and implement escalation processes
  • 5%: Assist in reporting timelines to Provider Enrollment Management Team
  • 5%: Other duties as necessary to support the success of the Provider Enrollment Department

Knowledge and Experience:

  • Bachelors Degree
  • Minimum five years of related healthcare experience, such as Medicare/Medicaid enrollment/billing or Managed Care enrollment/billing
  • Knowledge of NPPES and CAQH preferred

Skills Required:

  • Demonstrate ability to meet and exceed expectations
  • Communicate clearly and concisely
  • Demonstrate proficiency in Microsoft Office application and other applications as required
  • Demonstrates ability to organize, perform and track multiple tasks accurately in short timeframes
  • Ability to work quickly and accurately in a fast-paced environment while managing multiple demands
  • Ability to work both independently and collaboratively as a team player
  • Demonstrates adaptability, analytical and problem-solving skills with attention to detail
  • Ability to work effectively with other employees and external parties
  • Establish and maintain provider and payor relationships, building trust and respect

Physical Demands:

  • Prolonged periods of sitting/standing
  • Requires manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator and other office equipment
  • Occasional lifting and carrying up to 20 pounds

Mental Demands:

  • High level of mental awareness
  • High level detention to detail
Apply for this Position

Note: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.

*INTERNAL CANDIDATES: To be considered for an open position, you must be in good standing (i.e., not on a Performance Improvement Plan) and in your current position for at least six months. You must also meet the minimum requirements for the job and be able to perform the essential functions of the position.

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