Sr. Provider Enrollment Specialist

Location: Remote

Schedule: Monday through Friday, 8am to 4:30pm EST

GENERAL SUMMARY:

This position is responsible for the overall administration of the provider enrollment process for new and existing clients as well as assuring new client start-ups are being effectively managed.

Essential Duties and Responsibilities:

Preparing and submitting enrollment applications

Following up on the status of applications for clients

Keep detailed log of all pending and completed work

Maintain/Update credentialing reports

Manage new client start-up, group enrollment, and special projects

Communicate enrollment status to those involved on an as needed basis

Resolve issues related to provider or NPI numbers

Deactivation of provider numbers, effective dates, NPI related denials, NPI website, etc.

Manage state and client master applications

Foundation Knowledge, Skills, and/or Abilities Required: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Additional Duties and Responsibilities:

Other duties as assigned by your manager

Educational/Vocational/Previous Experience Recommendations:

High school diploma or equivalent required

3 - 5 years experience working in credentialing and/or enrollment preferred

Knowledge of provider enrollment process and requirements for commercial insurance companies, CMS Federal and State Guidelines related to enrollment policies preferred

Ability to effectively communicate both in writing and verbally, as well as to interact in a professional manner with colleagues, patients, public, and client’s staff members required

Proficient with MS Office products preferred

Ability to multi-task needed

Working Conditions:

Call Center Environment

Must be able to sit for extended periods of time

Benefits including but not limited to: Medical, Vision, Dental, 401K, Paid Time Off.

We are an Equal Opportunity Employer.  All qualified applicants are considered for employment without regard to race, color, age, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by federal, state or local law.

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