Managed Care Enrollment Representative

National Vision•Lawrenceville, GA

14h

About The Position

The Managed Care Store Enrollment Coordinator is responsible for overseeing and maintaining store enrollments with National Vision, Inc.'s (NVI) contracted Managed Care (MC) payors. This role involves a broad range of provider relations and service interactions between National Vision and the managed care payors, ensuring smooth operations and effective communication.

Requirements

2-4 years of Managed Care, customer service and/or administrative experience.
Strong database management and data entry skills.
Proficient in Microsoft Word and Excel.
Strong verbal/written communication abilities; effective interpersonal skills; strong attention to detail.
Highly organized with strong follow-up skills and the ability to multi-task.
Strong interpersonal and communication skills with the ability to work with a wide range of associates, teams, supervisors, directors, customers, and vendors.
Organized and detail-oriented even in a fast-paced environment.
Takes initiative and ownership for assigned tasks.
Produces quality work and contributes a positive attitude towards building successful relationships with others.
Has the ability to juggle multiple projects with multiple deadlines, often with minimal direction and supervision.
Resourceful and seeks out answers
Identifies opportunities for process improvements to workflows and is an active participant in making those changes to accomplish goals efficiently.

Nice To Haves

Two years of college or equivalent experience.

Responsibilities

Applies for and maintains documentation for each location’s National Provider Identifier.
Communicates new store information to the MC payors for enrollment in MC.
Serves as the point of contact with Managed Care payors throughout the new store opening process.
Sets up MC portal log-ins for NVI stores.
Communicates payor IDs and payor portal login information to the new stores.
Troubleshoots issues with payor setup or portal log-ins and assists stores in resolving problems.
Keeps payor directories up to date.
Assists in maintaining the database of managed care payors for stores and ODs.
Assists stores and other departments with questions regarding NVI’s participation with MC.
Analyzes managed care sales reports to identify problems and works with cross-functional departments to implement solutions.
Serves as a liaison between National Vision’s managed care customer service and billing departments to assist in the resolution of systemic claim issues and denials.
Diligently seeks assistance from the payors as needed and works swiftly to monitor and close the loop on issues as quickly as possible.