Provider Enrollment Specialist

Eye Care Partners Career Opportunities•Ballwin, MO

13h•$25•Remote

About The Position

Our growing eye care organization has an immediate need for an experienced Provider Enrollment Specialist who is familiar with provider data management and credentialing. A successful individual in this role will manage multiple enrollments and priorities while providing support to the Supervisor of Provider Enrollment.

Requirements

High School Diploma or GED Required
2+ years of related experience or training, equivalent combination of education and experience will be considered
Professional in appearance and actions
Logical and Critical thinking skills for problem solving and analysis.
In-depth knowledge of performance metrics
Customer-focused with excellent written, listening and verbal communication skills
Ability to maintain control of a call de-escalating issues and instilling confidence that a resolution will be found
Ability to function effectively under stress of conflicting demands on time and attention, while successfully meeting deadlines
Enjoys learning new technologies and systems
Detail oriented, professional attitude, reliable
Exhibits a positive attitude and is flexible in accepting work assignments and priorities
Meets attendance and tardiness expectations, ability to work overtime, if required.
Management and organizational skills to support the leadership of this function
Ability to follow or provide verbal & written instructions with sufficient grammar and spelling skills to avoid mistakes or misinterpretations
Interpersonal skills to support customer service, functional, and teammate support need
Able to communicate effectively in English, both verbally and in writing
Ability for basic to intermediate problem solving, including mathematics
Intermediate computer operation
Proficiency with Microsoft Excel, Word, PowerPoint and Outlook
Specialty knowledge of systems relating to job function
Knowledge of state and federal regulations for this position; general understanding of HIPAA guidelines
Proficient computer skills, particularly in Microsoft
Good understanding of insurance payers and enrollment methods.
Ability to diagnose and resolve basic enrollment issues
Excellent organizational skills
Desire to gain industry knowledge and training
Demonstrates initiative in accomplishing goals
Ability to grow, adapt, and accept change
Consistently creating a positive work environment by being team-oriented
Excellent verbal, written, and social skills.
Ability to work overtime if/when needed

Responsibilities

Enroll providers with payers by providing information to the payers as applicable. This includes Medicare, Medicaid, commercial plans, and MCOs.
Complete required documentation and applications for credentialing, recredentialing and privileging providers at assigned hospitals/ facilities.
Serve as the first point of contact for internal office and provider requests.
Maintain a database for provider credentialing and update the applicable software/ systems as needed to ensure all provider enrollment data is up-to-date and current.
Keep CAQH updated with accurate and current information.
Keep NPPES updated with accurate and current information.
Maintain constant contact with insurance payer representatives.
Communicate effectively any enrollment updates and issues to leadership.
Follow up with payers on outstanding enrollments on a weekly basis.
Maintain all demographic changes for all providers.
Maintain all hospital appointments and re-appointments.
Maintain and renew provider expirables (medical license, DEAs, board certification, malpractice insurance, etc.).