**Description** Hourly Wage Estimate: $17.36 - $26.05 / hour Learn more about the benefits offered ( https://careers.hcahealthcare.com/pages/employee-benefits-and-rewards ) 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. **Introduction** Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized. Submit your application for the opportunity below:Provider Enrollment Credentialing SpecialistParallon **Benefits** Parallon, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. + Free counseling services and resources for emotional, physical and financial wellbeing + 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service) + Employee Stock Purchase Plan with 10% off HCA Healthcare stock + Family support through fertility and family building benefits with Progyny and adoption assistance. + Referral services for child, elder and pet care, home and auto repair, event planning and more + Consumer discounts through Abenity and Consumer Discounts + Retirement readiness, rollover assistance services and preferred banking partnerships + Education assistance (tuition, student loan, certification support, dependent scholarships) + Colleague recognition program + Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence) + Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income. Learn more about Employee Benefits (https://careers.hcahealthcare.com/pages/employee-benefits-and-rewards) **_Note: Eligibility for benefits may vary by location._** We are seeking a Provider Enrollment Credentialing Specialist for our team to ensure that we continue to provide all patients with high quality, efficient care. Did you get into our industry for these reasons? We are an amazing team that works hard to support each other and are seeking a phenomenal addition like you who feels patient care is as meaningful as we do. We want you to apply! **Job Summary and Qualifications** The Provider Enrollment Credentialing Specialist is responsible for processing credentialing files and 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. **In this role you will:** + Ensure provider participation with contracted payors by taking appropriate next actions to complete enrollment, such as completing applications, rosters, and notifications + 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 + Prepare credentialing files for presentation to the Credentialing Committee or the Chief Medical Officer (CMO) + Confirm completeness and accuracy of credentialing files prior to committee presentation + Work closely with Provider Enrollment Manager to resolve credentialing file issues + Ensure payor requirements for submission of rosters are met Monitor inventory, including provisional, credentialing, and recredentialing for all providers as well as expirables to meet payor requirements + Assist during payor-delegated credentialing audits + Escalate items to other areas outside of department as needed + 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 + Maintain working knowledge of National Committee for Quality Assurance (NCQA) guidelines and state requirements + Adhere to established credentialing policy guidelines and procedures Practice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement” + Other duties as assigned **Qualifications:** + High school diploma or GED required + Minimum one year related healthcare experience preferred, such as Medicare/Medicaid Enrollment or Managed Care Enrollment. Relevant education may substitute experience requirement. Knowledge of provider credentialing and primary source verification, National Committee for Quality Assurance (NCQA) policies and procedures, state specific certificate and licensure requirements and site visit requirements, National Plan and Provider Enumeration System (NPPES) and Council for Affordable Quality Healthcare (CAQH) preferred. + Certified Provider Credentialing Specialist (CPCS) preferred. **Parallon** provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities. HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses. "There is so much good to do in the world and so many different ways to do it."- Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder If you find this opportunity compelling, we encourage you to apply for our Provider Enrollment Credentialing Specialist opening. We promptly review all applications. Highly qualified candidates will be directly contacted by a member of our team. **We are interviewing apply today!** 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.