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Position: Provider Enrollment Lead Job Code: PES001
Department: Provider Enrollment FLSA Status: Non- Exempt
Reports To: Provider Enrollment Manager
Job Summary
The Provider Enrollment Lead can function independently as well as a part of a team, working to prioritize projects appropriately. Responsibilities include preparing and submitting applications and supporting documentation for the purpose of enrolling individual physicians and physician groups with payers. Working closely with leadership and clients, to ensure that detailed reports and feedback occur in a proactive manner.
Qualifications
.Bachelor’s degree in a related field and/or the equivalent combination of training, education, and experience, required
- 3-5 Years Provider Enrollment/Credentialing experience required
- 1 year of leadership experience preferred
- Expert level knowledge of Microsoft Office (Word and Excel) required
- Excellent written and verbal communication skills
- Strong organization skills, ability to function independently, prioritizing tasks to meet deadlines
Responsibilities
. Manage the completion and submission of provider enrollment applications to payers
- Maintain documentation and reporting regarding provider enrollments in process
- Retain records related to completed provider enrollments
- Maintain provider enrollment information within the credentialing database
- Interact professionally with providers, ancillary staff, and plan representatives to provide appropriate and timely response to inquiries and concerns regarding provider
- Respond professionally to client inquiries regarding status of applications received
- Proactive follow up with insurance plans to monitor status of provider applications
- Research and contact providers to resolve enrollment application deficiencies
- Send out provider applications, forms and other provider correspondence as requested
- Maintain strict confidentiality of information as dictated by current HIPAA requirements
- Collaborate with leadership and teammates on process improvement
- Obtain and/or enter information in a timely and efficient manner
- Lead and/or Actively Participate in client and departmental meetings
- Account for internal control responsibilities in line with the organization’s objectives
- Ability to handle Protected Health Information in a manner consistent with the Health Insurance Portability and Accountability Act (HIPAA)
- Other duties as assigned
Job Type: Full-time
Pay: $18.00 - $25.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Day shift
- Monday to Friday
Education:
- Associate (Preferred)
Experience:
- Microsoft Office: 2 years (Required)
- Provider Enrollment: 3 years (Required)
- Leadership: 1 year (Required)
- Credentialing: 3 years (Required)
Work Location: Remote
