Provider Enrollment Representative II
About The Position
The healthcare system is always evolving — and it’s up to us to use our shared expertise to find new solutions that can keep up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career. Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team — including offering a competitive benefits package.
Requirements
- Minimum of 2 years of experience
- High School - Equivalent experience will be considered
Responsibilities
- Works in all phases of provider enrollment, re-enrollment, and expirables management, ensuring the timely and accurate enrollment (and recredentialing) of providers in commercial and government payers.
- Accurate data entry of up-to-date expirables, practice/billing locations, and other pertinent information to the payer enrollment database.
- Participate in review, completion, and/or submission of provider enrollment initial and re-enrollment applications for local and national commercial, Medicare, and Medicaid payers via payer online portals or other methods as applicable.
- Follow up with payers via phone, website, or email requesting network participation and follow up on submitted applications.
- Assist providers, and client personnel with completion of the application, routinely follow up with insurance carriers to monitor the status of applications and resolve issues.
- Facilitate completion, set-up and/or re-attestations of CAQH applications.
- Responsible for NPPES updates for individual and organization providers.
- Professional, friendly, and timely coordination and collaboration with providers and/or designated office personnel.
- Achieve monthly quality and productivity standards.
- Compliance with R1 policies.
- Performs other duties as assigned by the Provider Enrollment leadership.
- Assists with auditing, training, and educating peers and client team members with escalations and enrollment processes and paperwork.
- Supports team in identifying gaps and trends in enrollment processes and escalating to leadership for resolution.
Benefits
- competitive benefits package
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
