Provider Enrollment Specialist

Providence Anesthesiology Associates PA • Charlotte, NC

10d • Hybrid

About The Position

The Provider Enrollment Specialist is responsible for preparing and submitting credentialing applications and supporting documentation to enroll individual Physicians and Advanced Practice Providers with payers. In this role, the Provider Enrollment Specialist follows up on the status of applications for Clinicians and payers and tracks the progress on all pending applications. The position requires integrity, attention to detail, dependability, initiative, and a commitment to embrace company values.

Requirements

• High School Diploma/Ged required.
• Two (2) years of provider credentialing experience preferred.
• CPCS – Certified Provider Credentialing Specialist or PESC – Provider Enrollment Specialist Certification preferred.
• Demonstrated ability to exercise professional oral and written communication skills with all internal and external audiences.
• Experience with medical billing software systems is recommended. Strong Microsoft Excel, Microsoft Outlook, Word, and PowerPoint is required.
• Ability to organize and manage personal workload. Ability to achieve and maintain strong working knowledge of anesthesia billing operation practices. Ability to develop and execute corrective action plans.

Responsibilities

• Re-enrolls and re-credentials providers employed by Providence Anesthesiology Associates.
• Reports all issues, scope of service changes, and progress updates to Director of Provider Relations
• Maintains the timelines for all enrollment/credentialing schedules and provides updates to providers and other departments as needed.
• Reviews Provider Profile information to determine enrollment issues, and reports on actions taken to resolve those issues.
• Coordinates the receipt and processing of all credentialing data needed for enrollment, contracting, and other related purposes.
• Works closely with clinicians and Director of Provider Relations to obtain missing documentation for providers pertaining to provider enrollment. Obtains required clinician signatures and follows up with the carriers on documentation submitted.
• Responds to internal and external inquires on routine enrollment and contract matters.
• Ensures compliance with all Health Insurance Portability and Accountability Act (HIPAA) standards.
• Performs other duties as required or assigned within the scope of responsibility.

Benefits

• Strong workplace culture.
• We care about each other as people.
• We build relationships and connections beyond the time spent on the job.
• We offer a supportive, highly team-oriented work environment.
• We provide competitive total rewards including salary, benefits – Day 1, retirement, profit sharing, life insurance, paid time off, holidays, education reimbursement, employee recognition for birthdays and anniversaries, fun team building events, and more.
• We want you to succeed and our employer to employee relationship is proven to help you reach your goals and the goals of PAA.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED