Provider Enrollment Specialist

State of Utah • Salt Lake City, UT

8d • Hybrid

About The Position

Seeking candidates who excel in providing exceptional customer service to individuals over-the-phone and enjoy working in a fast-paced call center environment. The Claims Technician position has two primary functions, to answer incoming customer service calls from the medical community and public regarding provider enrollment credentialing, and other related information to enroll medical providers into the Medicaid system. The technician responds to phone, electronic, fax and mail inquiries regarding the status of provider applications, and explains and interprets Medicaid policies, guidelines, benefits and procedures regarding Medicaid. The Claims Technician is required to be logged into the phone system for up to 7 hours/day and takes between 40 to 60 calls a day.

Requirements

• Answers customer service calls regarding provider enrollment applications, credentialing and validations from providers.
• Enters, retrieves and/or corrects applications as needed in the PRISM system.
• Receives, researches and responds to incoming questions or complaints; provides information, explains policy and procedures, and/or facilitates a resolution.
• Prepares supporting documentation for policy/procedure changes for policy review.
• Writes or drafts correspondence, reports, documents and/or other written materials.
• Must reside in Utah or be in the process of relocating to Utah within 30 days of their start date.
• Must successfully pass a criminal history check.

Nice To Haves

• Spanish speaking skills
• Prior professional working experience with provider enrollment or credentialing

Responsibilities

• Answer incoming customer service calls from the medical community and public regarding provider enrollment credentialing, and other related information to enroll medical providers into the Medicaid system.
• Respond to phone, electronic, fax and mail inquiries regarding the status of provider applications.
• Explain and interpret Medicaid policies, guidelines, benefits and procedures regarding Medicaid.
• Enter, retrieve and/or correct applications as needed in the PRISM system.
• Receive, research and respond to incoming questions or complaints; provide information, explain policy and procedures, and/or facilitate a resolution.
• Prepare supporting documentation for policy/procedure changes for policy review.
• Write or draft correspondence, reports, documents and/or other written materials.

Benefits

• Job Stability: Enjoy the security and reliability of employment within a well-established organization.
• Career Growth: Develop valuable skills and gain opportunities for leadership within a large organization.
• Meaningful Work: Contribute to an important service that benefits the community and supports organizational goals.
• Supportive Work Environment: Be part of a team that values cooperation, strong work ethics, and mutual support.

What This Job Offers

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