Supervisor-Payer Enrollment na BMH Memphis Hospital

Supervisor Payer Enrollment
 

Job Summary:
A Payer Enrollment Supervisor is responsible for overseeing the day-to-day operations of a team of payer enrollment specialists. This role ensures that the team is meeting its goals and KPIs for processing provider enrollments and re-enrollments with insurance payers. The Supervisor manages workflows, provides guidance and support to the team, and addresses any issues that arise during the enrollment process. While the Supervisor plays an active role in the enrollment process, they also focus on team management, training, and ensuring that procedures are being followed accurately and efficiently.
 

Key Responsibilities:
•    Supervise and manage the daily activities of a team of payer enrollment specialists, ensuring efficient workflow and timely processing of provider enrollment applications.
•    Conduct regular team meetings to review enrollment goals, challenges, and improvements.
•    Ensure that the team is up to date with payer policies, procedures, and regulatory requirements.
•    Analyze and optimize payer enrollment workflows, identifying bottlenecks or areas for improvement to improve efficiency and compliance. Coordinate with other departments to streamline workflows and ensure proper data flow for accurate payer enrollment processing.
•    Provide coaching, training, and ongoing support to staff, addressing questions and resolving issues as they arise.
•    Assist in the development of training materials and guide staff on payer enrollment processes, best practices, and troubleshooting techniques.
•    Assist in resolving complex or escalated enrollment issues, collaborating with internal departments (e.g., credentialing, billing) or payer representatives as needed.
•    Monitor team performance to ensure adherence to established performance metrics and KPIs, addressing any areas of underperformance.
•    Provide regular reports to upper management on team performance, progress towards goals, and any outstanding issues.

Experience
•    3–5 years of experience in payer enrollment, credentialing, or a related healthcare administrative role, with at least 1–2 years in a supervisory or team lead capacity.
•    Direct experience with payer enrollment processes, including provider data entry, application submission, and payer-specific requirements.
•    Experience handling a variety of payer contracts and understanding of credentialing and revalidation processes.
•    Previous work in managing provider enrollment for multiple insurance carriers.
•    Experience with payer systems (e.g., CAQH, PECOS, payer portals) and healthcare management software (e.g., MD-Staff, Epic).

Education
•    Minimum Education:
o    Associate’s degree in Healthcare Administration, Business Administration, Health Information Management, or a related field, or equivalent years of experience.
•    Preferred Education:
o    Bachelor’s degree in Healthcare Administration, Business Administration, or a similar discipline.
•    Certifications (Optional):
o    Certified Payer Enrollment Specialist (CPES), when eligible