Provider Enrollment Specialist II

Easterseals MORC•Auburn Hills, MI

About The Position

Easterseals MORC is hiring for a Provider Enrollment Specialist to help make a difference and become part of something bigger than yourself! We are looking for Game Changers! The types of people who wake up excited to make a difference. The superheroes of their field who care about the people they serve. If that sounds like you, we want you on our team.

Requirements

High School Diploma or equivilent
Two years experience in clinic, business, or medical office preferred
One year of Provider Enrollment exprience preferred
Excellent organizational and project planning skills with the ability to work on several projects simultaneously, work well under pressure, and meet deadlines.

Responsibilities

Facilitate enrollment of new Easterseals MORC providers to ensure proper and timely billing and collections
Prepare enrollment applications for all health plans including Medicare and Medicaid
Complete data entry and processing of enrollment applications, with validation of provider submitted information to ensure the application is complete, accurate, and meeting Easterseals MORC standards
Obtain licensure, certification and insurance certificates at time of enrollment and maintain in database in order to submit with enrollment applications
Maintain timelines on enrollment processes, and address and/or escalate any delays
Ensure that all pending enrollments are reviewed, obtained and managed according to the rules and policies of the department
Provide monthly notification of new providers, resignations, and changes in provider status such as practice locations and panel status to contracted plans
Follow up with necessary contacts, including providers and managed care organizations, to resolve enrollment application issues and deficiencies
Facilitate resolution of provider related denials to ensure appeal procedures are followed to result in proper reimbursement
Demonstrate a level of competence and understanding of all state and federal laws, rules and regulations according to payer guidelines for billing

Benefits

Low-cost Dental/Health/Vision insurance
Dependent care reimbursement, and up to 5 days paid FMLA for maternity, paternity, foster care and adoption.
Generous 401K retirement plan
Paid Leave Options Available
Up to $125 bonus for taking 5 days off in a row.
10 paid holidays and 3 floating holidays (Over 30 days total of paid time off)
Wellness Programs
We are a PSLF (Public Service Loan Forgiveness) Employer.
We provide bonuses and extra incentives to reward hard work & dedication.
Mileage reimbursement in accordance with IRS rate.
Free financial planning services through our partnerships with the LoVasco Consulting Group, and SoFi.
Student loan repayment options
Pet Insurance