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

Location : Miramar, Florida

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 :

Provides status reports of plan participation, as necessary.Maintains all physician enrollment documentation and documentation status for all physicians with Medicare, Medicaid, and Managed Care Plans.

Enrolls all new providers with Medicare, Medicaid and all Managed Care Plans.Re-enrollment / re-validation of all providers with Medicare, Medicaid, and Managed Care Plans.

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 opportunities without regard to race, color, age, religion, gender, gender identity or expression, sexual orientation, national origin, veteran status, disability, genetic information, or any factor prohibited by law.

We are proud to offer Veteran’s Preference to former military, reservists and military spouses (including widows and widowers).

You must indicate your status on your application to take advantage of this program.

Employment is subject to post offer, pre-placement assessment, including drug testing.

If you need reasonable accommodation during the application process, please call 954-276-8340 (M-F, 8am-5pm) or email