Provider Enrollment Specialist

Job Title: Provider Enrollment Specialist

MUST LIVE IN ONE OF OUR 18 States: Missouri, Florida, Kansas, Kentucky, Pennsylvania, Virginia, New Jersey, Texas, Minnesota, Michigan, Oklahoma, Alabama, North Carolina, Georgia, Illinois, Ohio, Indiana, Arizona

Pay: $25.00/hr; No Negotiation

Job Summary

Our growing eye care organization has an immediate need for an experienced Provider Enrollment Specialist who is familiar with provider data management and credentialing. A successful individual in this role will manage multiple enrollments and priorities while providing support to the Supervisor of Provider Enrollment.

Duties and Responsibilities

• Serve as the first point of contact for internal office and provider requests.
• Keep all provider enrollment data up-to-date and current.
• Complete re-credentialing paperwork as needed.
• Keep all internal enrollment tracking methods up to date.
• Detailed understanding of Medicare, Medicaid, and Managed Care Plan regulations
• Keep CAQH and NPPES updated with accurate and current information.
• Maintain constant contact with insurance payer representatives.
• Communicate enrollment updates and issues to leadership.
• Follow up with payers on outstanding enrollments on a weekly basis.
• Maintain all demographic changes for all providers.
• Maintain all hospital appointments and re-appointments.
• Performs other duties that may be necessary or in the best interest of the organization

Education:

High School Diploma or GED Required

Experience Requirements

• 2+ years of related experience or training, equivalent combination of education and experience will be considered

Knowledge, Skills and Abilities Requirements

• Professional in appearance and actions
• Logical and Critical thinking skills for problem solving and analysis.
• In-depth knowledge of performance metrics
• Customer-focused with excellent written, listening and verbal communication skills
• Ability to maintain control of a call de-escalating issues and instilling confidence that a resolution will be found
• Ability to function effectively under stress of conflicting demands on time and attention, while successfully meeting deadlines
• Enjoys learning new technologies and systems • Detail oriented, professional attitude, reliable
• Exhibits a positive attitude and is flexible in accepting work assignments and priorities
• Meets attendance and tardiness expectations, ability to work overtime, if required.
• Management and organizational skills to support the leadership of this function
• Ability to follow or provide verbal & written instructions with sufficient grammar and spelling skills to avoid mistakes or misinterpretations
• Interpersonal skills to support customer service, functional, and teammate support need
• Able to communicate effectively in English, both verbally and in writing
• Ability for basic to intermediate problem solving, including mathematics
• Intermediate computer operation
• Proficiency with Microsoft Excel, Word, PowerPoint and Outlook
• Specialty knowledge of systems relating to job function
• Knowledge of state and federal regulations for this position; general understanding of HIPAA guidelines

Job descriptions are intended to be accurate reflections of those principal job elements essential for making fair pay decisions about jobs. Nothing in this job description restricts management right to assign or reassign duties and responsibilities to this job at any time.

Physical Requirements:

While performing the duties of this job, the employee is regularly required to talk and hear. The employee is occasionally required to stoop, kneel, crouch or crawl. The employee must frequently lift and/or move up to 10 pounds.

Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

If you need assistance with this application, please contact (636) 227-2600

EyeCare Partners is an equal opportunity/affirmative action employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.

Please do not contact the office directly - only resumes submitted through this website will be considered.