Jobs
>
Philadelphia

    Provider Enrollment Specialist - Philadelphia, United States - Global Force

    Default job background
    Description

    Provider Enrollment Specialist

    Location :
    Philadelphia PA
    19113

    Contract: 3 months with possibility of extension

    Under the direct supervision of the Provider Enrollment Supervisor, the Provider Enrollment Specialist is responsible for maintaining both participating and non-participating provider records in the provider database, mapping claims in the invalid provider queue, resolving provider related issues for claims suspended to Provider Enrollment.

    Executes the panel transfer process. Completes projects as assigned by Supervisor. Interacts with internal/external clients on provider maintenance activities.


    • Communicates notification of changes to appropriate providers, members and other departments within the contracted time frame.
    • Coordinates the provider mailing for all claims in the invalid provider queue that could not be processed due to missing or invalid information.
    • Researches and resolves returned checks and provider mail.
    • ssists provider and internal customer by responding to and resolving all request and inquiries related to the Panel Transfers, Panel Releases, & Special Needs PCP assignments process.
    • Completes department reports and logs as assigned.
    • Ensures that work is completed according to service level agreements.
    • ttends required training on an annual basis.

    Skills:
    Knowledge of different types of providers, claims process exp preferred.
    Customer service exp required.
    Software systems including Windows 2000, MS Office, IMAX (external Claims editing),
    Facets preferred.
    Knowledge of Word, Excel, and ACCESS is a plus.
    1-3 Years of Healthcare Experience
    Minimum 4 years exp in claims and/or call center


    Education:
    Associates Degree


  • Trinity Health Philadelphia, United States

    Employment Type: · Full timeShift: · Day Shift · Description: · Enrollment Specialist · Shift: Typical work schedule is Monday to Friday, 8 am to 5 pm with occasional evening or weekend hours required. · Status: Full time · Location: Mercy LIFE West Philadelphia · Incenti ...


  • Trinity Health Philadelphia, United States

    Employment Type: · Full time · Shift: · Day Shift · Description: · Enrollment Specialist · Shift: Typical work schedule is Monday to Friday, 8 am to 5 pm with occasional evening or weekend hours required. · Status: Full time · Location: Mercy LIFE West Philadelphia · Incentives: ...


  • Wilmington Community Clinic Wilmington, United States

    **Join Wilmington Community Clinic** · Have you ever wanted to be a part of something bigger? Have you ever wanted to make a difference? At Wilmington Community Clinic, here you can. WCC provides quality, non-discriminatory primary care, mental health, dental and women's health s ...


  • DM Clinical Research Philadelphia, United States

    Job Description · Job DescriptionPatient Enrollment Specialist (Onsite) The Patient Enrollment Specialist exhibits excellent verbal and written communication skills, will be detail oriented and organized, and will communicate with current and potential DM patients via phone, text ...


  • Nemours Wilmington, United States

    Nemours is seeking a Provider Enrollment Specialist (hybrid) to join our Nemours Children's Health team in Delaware or Florida. · This position is responsible for administrative and technical duties that require accuracy and attention to detail in the enrollment and reenrollment ...


  • Trinity Health Sharon Hill, United States

    Employment Type: · Full time · Shift: · Description: · Enrollment Specialist · Shift: Typical work schedule is Monday to Friday, 8 am to 5 pm with occasional evening or weekend hours required. · Status: Full time · Location: Mercy LIFE Sharon Hill · Incentives: $5,000 Sign on Bon ...


  • AbsoluteCARE Inc Philadelphia, United States

    · Description: · AbsoluteCare offers concierge health services using a risk-bearing, PCP-driven care model. We treat the most clinically complex and vulnerable members of the communities we serve, many of whom suffer from behavioral health, substance use, and SDoH challenges. W ...


  • AbsoluteCare Philadelphia, United States

    Description: · Absolute Care offers concierge health services using a risk-bearing, PCP-driven care model. We treat the most clinically complex and vulnerable members of the communities we serve, many of whom suffer from behavioral health, substance use, and SDoH challenges. We ...


  • Mastery Charter Camden, United States Part time

    **Bilingual Enrollment Support Specialist (Part-Time) - IMMEDIATE School Year** · Camden, NJ / Network Support External Strategy / Part-Time School Year **About Mastery:** We believe educational inequity is the most pressing social problem facing our country and the civil rights ...


  • Westside Family Healthcare Wilmington, United States

    Job Type · Full-time · Description · WESTSIDE IS LOOKING FOR ENROLLMENT SPECIALISTS JOIN THE TEAM THAT MAKES A DIFFERENCE · JOIN A CARING, DEDICATED TEAM WHO HELPS PATIENTS AND FAMILIES GAIN ACCESS TO HEALTHCARE, AND NAVIGATE COMMUNITY SERVICES AND RESOURCES. · Westside Family ...

  • GeoBlue

    Enrollment Specialist

    3 weeks ago


    GeoBlue King of Prussia, United States

    We are hiring for Enrollment Specialists to join the team The Enrollment Specialist role will process all eligibility and financial transactions as assigned; regularly correspond with brokers and clients regarding enrollment issues, payment issues; assists brokers and FSAs with i ...

  • Worldwide Insurance Services

    Enrollment Specialist

    3 weeks ago


    Worldwide Insurance Services King of Prussia, United States

    Job Description · Job DescriptionWe are hiring for Enrollment Specialists to join the team The Enrollment Specialist role will process all eligibility and financial transactions as assigned; regularly correspond with brokers and clients regarding enrollment issues, payment issues ...

  • McLaren Health Care

    Enrollment Specialist

    4 weeks ago


    McLaren Health Care Grand Blanc, United States

    **Position Summary:** · Responsible for maintaining and updating the initial credentialing and/or re-credentialing of providers or facilities with third party payers and institutional enrollment requirements for governmental programs for the McLaren Health Care system. Works in c ...


  • McLaren Health Care Grand Blanc, United States

    Position Summary · Responsible for maintaining and updating the initial credentialing and/or re-credentialing of providers or facilities with third party payers and institutional enrollment requirements for governmental programs for the McLaren Health Care system. Works in colla ...


  • PeopleShare Inc King of Prussia, United States

    Are you ready to take your customer service skills to new heights? Do you thrive in a dynamic and creative environment? · PeopleShare is on the lookout for an exceptional Student Enrollment Specialist's to be the heartbeat of a virtual school in the greater Philadelphia area If ...


  • PeopleShare King of Prussia, United States Temporary

    Are you ready to take your customer service skills to new heights? Do you thrive in a dynamic and creative environment? · PeopleShare is on the lookout for an exceptional Student Enrollment Specialist's to be the heartbeat of a virtual school in the greater Philadelphia area If y ...


  • Nemours Wilmington, United States Full time

    Nemours is seeking a Provider Enrollment Specialist (hybrid) to join our Nemours Children's Health team in Delaware or Florida.This position is responsible for administrative and technical duties that require accuracy and attention to detail in the enrollment and reenrollment of ...


  • Mastery Charter Camden, United States Part time

    **IMMEDIATE - Bilingual Enrollment Support Specialist (Part-Time School Year** · Camden, NJ / Network Support External Strategy / Part-Time School Year **About Mastery:** We believe educational inequity is the most pressing social problem facing our country and the civil rights ...


  • Devereux Advanced Behavioral Health West Chester, United States

    Are you interested data collection and reporting? Do you enjoy connecting with outside systems (school districts, parents, referral sources) and being a primary point of contact for school services offered? · If you answered YES, then consider joining our Devereux Advanced Behavi ...


  • Devereux Advanced Behavioral Health West Chester, United States

    : · Are you interested data collection and reporting? Do you enjoy connecting with outside systems (school districts, parents, referral sources) and being a primary point of contact for school services offered? · If you answered YES, then consider joining our Devereux Advanced ...