Provider Enrollment Specialist

Eye Care Partners CareerBallwin, MO
4h$25Remote

About The Position

EyeCare Partners is the nation’s leading provider of clinically integrated eye care. Our national network of over 300 ophthalmologists and 700 optometrists provides a lifetime of care to our patients with a mission to enhance vision, advance eye care and improve lives. Based in St. Louis, Missouri, over 650 ECP-affiliated practice locations provide care in 18 states and 80 markets, providing services that span the eye care continuum. For more information, visit www.eyecare-partners.com . Job Title: Provider Enrollment Specialist MUST LIVE IN ONE OF OUR 18 States: Missouri, Florida, Kansas, Kentucky, Pennsylvania, Virginia, New Jersey, Texas, Minnesota, Michigan, Oklahoma, Alabama, North Carolina, Georgia, Illinois, Ohio, Indiana, Arizona Pay: $25.00/hr; No Negotiation Job Summary 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.).
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