PROVIDER ENROLLMENT SPECIALIST

The Kroger Co. • Cincinnati, OH

11h

About The Position

The Provider Enrollment Specialist obtains, tracks, and coordinates required enrollment and reenrollment information from Nurse Practitioners, Physician Assistants, Collaborating Physicians, Licensed Practical Nurses, Registered Nurses, and other licensed medical professionals whose services may be reimbursable by payors or are required by law. The specialist submits necessary information to the organizations, agencies, affiliates, and third-party payors that require it. The role also requires demonstrating the company’s core values of respect, honesty, integrity, diversity, inclusion, and safety.

Requirements

• High-level knowledge of payor credentialing processes.
• Good working knowledge of the MS Office Suite.
• Excellent organizational skills and attention to detail.
• Excellent written and oral communication skills.

Nice To Haves

• One year of payor credentialing experience.
• Experience setting up new group practices and experience in a hospital credentialing or provider enrollment department.
• Experience with large commercial and government third-party payors.

Responsibilities

• Obtain and submit required information to enroll and reenroll healthcare providers.
• Facilitate completion of all payor applications.
• Maintain enrollment database information, including provider licenses, provider numbers, and related requirements for NPs, PAs, CPs, and PCTs.
• Track enrollment status with each required organization, agency, affiliate, and third-party payor.
• Establish and maintain strong working relationships with company clinicians, third-party payors, medical professional boards, and state and federal agencies.
• Continuously track provider enrollment status and communicate as necessary with other company departments.
• Perform the essential functions of the position with or without reasonable accommodation.

What This Job Offers

• Job Type: Full-time
• Education Level: No Education Listed