4550- Provider Services Specialist

Innovaccer Analytics

6d

About The Position

The Provider Services Specialist is responsible for the completion of enrollment tasks and the follow-up on credentialing-based holds and denials. The ideal candidate for the position follows the key performance goals as established by Caduceus for its client base of large-scale, multi-specialty healthcare organizations. The Provider Services Specialist is responsible for the escalation of new and existing issues: fielding, escalating, tracking, and trending payer, provider, or billing platform issues identified by his or her team and communicated to client and Caduceus management.

Requirements

• Athena Experience required.
• Experience working in a medical billing environment where compliance with protected health information and HIPAA compliance is strongly enforced.
• Excellent written and verbal communication skills with superior attention to detail.
• Ability to multi-task under tight timelines with strong administrative and exceptional organizational skills.
• Proficient in Microsoft Office Suite; Word, Excel, PowerPoint, and Outlook.
• Advanced knowledge credentialing databases or reporting systems.

Nice To Haves

• Bachelor’s degree preferred or equivalent experience in business/healthcare environment.
• 3+ years of applicable experience in credentialing and enrollment.
• Multi-specialty experience is a big plus.

Responsibilities

• Demonstrates a thorough knowledge and proficiency in all aspects of provider enrollment in a professional healthcare practice setting.
• Provides support on front end holds and back-end denials with a goal of follow up and resolution.
• Reports on new and existing issues to upper administration.
• Processes tasks from Enrollment Worklist including Credentialing Status, Payer Affiliation, Forms, and Online Enrollments. Assist with EDI, ERA, EFT, and Athena payor portal access.
• Updates and maintains all Payer Enrollment groups and statuses as directed by lead or administration.
• Possess a working knowledge and effective navigation of insurance portals including CAQH.
• Acts as liaison with Practitioners, billing management and insurance carriers.
• Performs other assigned duties/tasks.
• Demonstrates mastery of the above essential functions with passing grades in testing environment.

Benefits

• Generous Paid Time Off: 20 days of fixed time off per year, in addition to company holidays.
• Best-in-Class Parental Leave
• Recognition & Rewards: monetary incentives and company-wide recognition.
• Comprehensive Insurance Coverage: medical, dental, and vision insurance.
• 100% company-paid short- and long-term disability and basic life insurance.
• Optional perks include discounted legal aid and pet insurance.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree