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Why You’ll Love This Job

The Provider Enrollment Specialist facilitates the application process for new providers through all stages enrolling the provider with commercial and governmental payors as well as partner facilities. The Specialist is also responsible for updating practitioner information in both the internal software and with external payors. In addition to data entry, the specialist also maintains copies of licensure, certificates, and other documents necessary for the enrollment process, maintains provider CAQH profiles, and conducts verification of all data, ensuring accuracy and timely entry of information. The specialist shares essential updates with providers and the internal team as necessary.

Job Duties and Responsibilities

  • Adheres to deadlines and enrollment schedules by tracking files through all stages
  • Communicates with providers, payors, and MSOs via email, phone, and mail.
  • Maintains confidentiality and responsibility for all enrollment files through the process
  • Knowledge of medical credentialing and privileging procedures and standards
  • Willingness to establish and maintain effective work relationships with providers, payors, MSOs, co-workers, supervisors and/or manager.
  •  Ability to analyze, interpret and draw inferences from research findings and prepare reports.

Qualifications

  • Preferred 2 years’ provider enrollment experience
  • High School Diploma or GED
  • Strong communication skills as you will be speaking with payors, facilities, medical billing staff, and/or clients
  • Ability to work independently in a fast-paced environment while remaining calm and professional
  • Database management skills including querying, reporting, and document generation.
  • Must be able to multi-task
  • Excellent organizational skills and must be detailed oriented
  • Proficiency in Microsoft Office
  • Strong computer and typing skills
  • Positive, friendly, approachable disposition
  • Ability to work with multiple priorities

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Type: Full Time (Hourly)
Job ID: 53000