Job Description
Job Description
Location: Nashville, TN
Employment Type: Full-Time, M-F hybrid role
AP Health is a private practice comprised of advanced practice providers. We provide perioperative services to hospitals, surgeons, and surgery centers. This role will specialize in payer enrollment operations for our facility-based model.
What you will do:
- Oversee and execute end-to-end provider enrollment processes with in-network payers while maintaining an active roster
- Collaborate with Revenue Cycle team to understand payer policies and requirements
- Connect with providers and payers to efficiently complete the enrollment process
- Navigate payer portals like Availity, Optum, and others to submit enrollment applications, track statuses, and resolve enrollment delays
- Communicate with our People Operations team during the provider onboarding process to gather information and begin timely enrollments
- Manage providers CAQH profiles through employee lifecycle
- Assist in establishing Revenue Cycle SOPs and data workflows, providing feedback on enhancements for internal software and external leveraged resources
What do you need:
- 1-2 years of experience in healthcare revenue cycle, with 1-2 years managing payer enrollments (Medicare, Medicaid, and Commerical)
- Knowledge of payer enrollment processes and reimbursement rules
- Familiarity with portals like Availity and Optum
- Comply with HIPAA regulations and other healthcare standards
- Excellent communication and collaboration skills with a problem-solving approach
- Preferred Associate’s or Bachelor’s in healthcare administration, business, or related field (*equivalent experience also accepted)
- Preferred certifications in PECOS/CAQH training, CPC (AAPC)
Benefits:
- Comprehensive and flexible medical, dental, and vision insurance
- Short and long-term disability, basic and supplemental life
- 401K retirement plan with company matching
- Participation in the company’s Employee Stock Option Plan (ESOP)
- Paid state license, malpractice, and other agreed upon licenses and dues
- Tuition reimbursement
- Annual $1,500 allotment accompanied by 3 paid days off for Continuing Medical Education (CME)
- Generous PTO and "life/work" balance
- Excellence at Work: AP Health is a certified Great Place to Work™- a national designation based on employee feedback about trust, workplace culture, and experience.