- Flexible schedules and work-from-home opportunities
- Strong track record of providing excellent work/life balance
- Comprehensive benefits package and competitive compensation
- Commitment to fostering an inclusive culture of belonging and empowerment through our core values - collaboration, courage, agility, and respect.
- Process and maintain provider applications for enrollment and re-enrollment for Medicare, Medicaid, BCBS and/or Commercial payors in accordance with Federal and State guidelines.
- Prioritize and manage multiple enrollments in a deadline-driven environment.
- Distribute, log, receive and scan Provider Enrollment Packets as assigned.
- Update National Provider Database information as needed.
- Monitor credentials, i.e. Medical License, DEA to ensure they are active and in good standing.
- Submit updated credentials to payors when credentials have expired to ensure no lapse in enrollment.
- Serve as the primary contact for providers and payors when questions regarding enrollment/re-enrollment arise.
- Identify any issues with providers eligibility to participate in Government plans.
- Advise Supervisor/Manager immediately of any eligibility issues for providers.
- Procure all documents needed from Provider to enroll timely.
- Perform data entry of submitted applications in Provider database record along with any documentation related to the enrollment process.
- Perform follow up on submissions via online, email or phone according to policies and procedures to ensure timely approval is received.
- Monitor Provider Enrollment AR on Hold reports for any held enrollment that should not be holding and identify and research any providers withheld AR of 120 days to ensure no issues exist.
- HS Diploma required.
- B.A. in Healthcare or Business Administration or equivalent experience preferred.
- Work independently utilizing documented processes and automated daily reports generated from database.
- Must work independently with little or no oversight.
- When payor requirements change, must be able to analyze and compare processes in order to recommend process solutions to Management.
- Agility in managing multiple priorities with strong organizational and time management skills.
- Knowledge of Payor Credentialing processes, both Par and Non-Par.
- Knowledge of Provider Credentials.
- Experience working in CAQH database and National Provider Identifier database
- Knowledge of CMS Regulations and guidelines.
- Check out our LinkedIn Page
- Like us on Facebook
- Follow us on Twitter
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Provider Enrollment Specialist II - Lafayette, United States - SCP Health
Description
The position will be onsite in Lafayette.
At SCP Health, what you do mattersAs part of the SCP Health team, you have an opportunity to make a difference. At our core, we work to bring hospitals and healers together in the pursuit of clinical effectiveness. With a portfolio of over 8 million patients, 7500 providers, 30 states, and 400 healthcare facilities, SCP Health is a leader in clinical practice management spanning the entire continuum of care, including emergency medicine, hospital medicine, wellness, telemedicine, intensive care, and ambulatory care.
Why you will love working here:
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