Provider Enrollment Associate

Geode Health

6d•$23 - $25•Hybrid

About The Position

Geode Health is a rapidly growing, national provider of outpatient mental health services. Our Mission is to “Transform mental health by making it more accessible, affordable and effective”. Reporting to Credentialing Manager, the Provider Enrollment Associate is responsible for overseeing all credentialing, licensing, and payer enrollment tasks. The associate will work with providers and third-party partners to ensure all payer enrollment actions are completed in a timely manner while focusing on reducing overall enrollment related timelines. The Provider Enrollment Associate must be able to effectively communicate with providers and other internal/external customers.

Requirements

In-depth knowledge of credentialing, licensure, and payer enrollment requirements
Experience using PECOS, CAQH, Availity and other payer portals
Experience with EDI, ERA & EFT enrollments
Proficient with MS Excel and PowerPoint
Associate degree or equivalent experience required
3-5 years’ experience working in provider enrollment

Nice To Haves

Passionate about our mission and inspiring others
Organized & process-oriented
Customer service experience is preferred
Excellent communication skills, both verbal and written
Self-starter, for whom no task is too big or too small and takes ownership of their decisions
Contributes to the collective effort both within own scope - and beyond - as needed
Creative and strategic thinker, who will dig for answers
A lifelong learner who believes in giving and receiving feedback to get better each day
Bachelor’s Degree preferred.

Responsibilities

Act as a liaison to providers as well as any vendors to ensure all information required for credentialing, license verification and payer enrollment is obtained in a timely manner
Provide credentialing and enrollment expertise for the organization
Leverage expertise to develop third-party workers’ knowledge base through regular meetings and coaching
Maintain accuracy of provider database including payer enrollment, licensure, and malpractice information
Provide regular reporting of any delays in credentialing or enrollment processes
Responsible for investigating and self-reporting issues, developing and implementing solutions to address existing issues and identifying processes to mitigate risk
Assists in resolving payer enrollment related claim denials
Continually monitor processes and outcomes to ensure established KPI’s for credentialing, licensure and enrollment tasks are met
Provide feedback to Payer Contracting to ensure payer specific requirements are not only met, but optimized to reduce enrollment timelines
Ability to learn and document regulations and rules for new states
Other duties as assigned

Benefits

Competitive compensation
Medical, dental and vision benefits
Life insurance
Short and long-term disability
Paid vacation and holidays
Matching 401k plan
State of the art technology
Flexible schedule
In-person and virtual patient visits
Comprehensive admin support (front office, accounting, finance, payroll, HR, etc)
Professional development opportunities
Clinical community, support, and leadership