Provider Enrollment Specialist II

North American Partners in Anesthesia

91d • $19 - $26

About The Position

The Provider Enrollment Specialist II will be responsible for the larger and/or overarching functions of the provider enrollment credentialing process they manage within team territories they are assigned such as larger payors, special tasks, Government payors or Provider Liaison services.

Requirements

• Positive and professional attitude.
• Ability to work with all levels of associates from entry level to upper-level management.
• Ability to work independently or in a group setting.
• Previous credentialing or enrollment experience a plus.
• Strong knowledge of provider enrollment credentialing in a physician office, managed care or hospital setting.
• Must be a self-starter and a team player who enjoys providing the highest level of customer service.
• Experience working with databases, and ability to create and manipulate excel spreadsheets.
• Ability to multi-task and prioritize in a fast-paced environment.
• Strong communication and follow up skills.
• Professional business sense and leadership skills.
• Strong experience with Microsoft Office (Excel & Word specifically).
• Local & distance travel may be required.

Nice To Haves

• Associates Degree, Bachelor’s Degree, and/or equivalent work experience.
• A minimum of three years provider enrollment/credentialing experience.

Responsibilities

• Complete and accurately submit provider enrollment applications, spreadsheets, and letters.
• Research & keep current on payer, hospital, ASC & office-based guidelines as needed to ensure processes are accurate.
• Review and create workflows to identify accuracy, efficiency, and best practices.
• Assist provider enrollment credentialing staff in their zone/region, monitor workflows, and provide support and training as required.
• Follow up with payors to ensure timely enrollment, re-enrollment, and participation.
• Review and follow up on weekly billing reports.
• Data entry of all provider information into the Credentialing Database.
• Handle incoming requests from physicians, payors, and other agencies.
• Verify integrity of data.
• Oversee the completion of online provider CAQH re-attestations.
• Assist with the development and maintenance of departmental policies and procedures.
• Assist/lead new business implementations.
• Assist in internal departments by resolving payment and denial issues as it relates to credentialing.
• Travel between hospitals and other clinical work locations to meet with providers to obtain signatures on required documents as needed.
• Facilitate and attend meetings and seminars as required.
• Produce weekly and monthly productivity and issues report for management.
• Other responsibilities as assigned.

Benefits

• Paid Time Off
• Health, life, vision, dental, disability, and AD&D insurance
• Flexible Spending Accounts/Health Savings Accounts
• 401(k)
• Leadership and professional development opportunities

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree