Enrollment Specialist

Deer Oaks•San Antonio, TX

15h

About The Position

Enrollment Specialists are responsible for maintaining the Credentialing portal and filling the gaps in the payer enrollment process at the individual, group, and facility levels.

Requirements

High school diploma or equivalent
2 years of relevant healthcare/provider credentialing experience
Experience with full cycle enrollments in Medicare, Medicaid, and Managed Care Plans
Knowledgeable of assigned states credentialing and payer requirements
Experience with state licensure enrollments
Ability to multi-task and prioritize work to meet deadlines
Excellent verbal and written communication skills
Positive customer service attitude
Ability to research and analyze data, and work independently with minimal supervision

Nice To Haves

Associates degree preferred

Responsibilities

Acts as a liaison between Deer Oaks’ clinicians and the credentialing partner
Enrolls clinicians to obtain an NPI number if the clinicians do not have one already
Assists in creating CAQH ID/Account if needed by the clinicians
Populates portal with SSN/CAQH ID/Last name to kick off documentation gathering
Works with the clinicians to gather and upload, missing documentation within the credentialing portal
Establishes surrogacy relationship with clinicians and the credentialing partner
Submits requests for enrollment at the individual, group, and facility level for all payers
Obtains additional documents as needed during enrollment including the facilitation of site inspections if required
EHR enrollment support (PointClickCare)
Adds or changes submissions based on new or changed plans and informs the credentialing partner
Fulfills facility credentialing requests from facilities providing CV, license, COI, etc.
Updates the clinicians’ taxonomy with NPPES/NPI when needed and communicates changes to the Director
Updates name changes or records license certification updates
Tracks collaborative agreements and supervision in the portal
Executes service location reports for payers, including roster submissions
Assists with the tracking of CEUs
Adds and maintains locations and facilities in the portal
Monitors dashboard to track progress of enrollments and provide any information needed
Monitors expiration dates and keeps all enrollments, individual or group, active
Manages Medicaid portals, including linking all places of service to the group when required, and submitting license renewals to maintain Medicaid enrollment.