Provider Enrollment Specialist

Overview

SUMMARYUnder general supervision, the Enrollment Specialist is responsible for a variety of tasks relating to healthcare provider enrollment. The Enrollment Specialist contacts providers along with government and commercial payers to complete the enrollment process and maintain the status logs of applications. Additionally, the enrollment specialist communicates with the billing department to resolve provider enrollment items.EDUCATION AND EXPERIENCE

High school diploma or equivalent required

Two years of college experience preferred (emphasis on Business Administration or Healthcare Management) OR three to five years of enrollment experience

Responsibilities

CHARACTERISTIC JOB TASKS AND RESPONSIBILITIESMay include any and/or all of the following:

• Complete and maintain ALL provider enrollment applications (government and commercial)
• Strong follow up with submitted applications for all payors
• Have knowledge of provider enrollment processes across several states, primarily AR, CO, DE, GA, KY, MD, MI, MS, NV, OH, TN and TX
• Interact professionally with providers and ancillary staff to provide appropriate and timely responses
• Work closely with billing team to identify and resolve enrollment billing issues
• Provide routine and thorough enrollment updates to the billing team to identity and resolve enrollment billing issues in a timely manner.
• Completes all enrollment requirements within 90 to 120 days from the time a provider’s credentialing/enrollment applications are received unless otherwise notated.
• Can navigate Verity to load, run bolt reports and create forms on provider data.
• Maintain providers in Avid and the hold queue to release all holds for providers as approved by payers and make sure that claims have been filed once hold has been released.
• Interact with payers to research, request and obtain initial payer contracts for enrollment.
• Ability to work in a fast-paced environment

Qualifications

KNOWLEDGE, SKILLS, ABILITIES AND PERSONAL CHARACTERISTICS

• Excellent organizational skills and attention to detail.
• Ability to think strategically and prioritize the day-to-day tasks in an efficient manner
• Ability to maintain a high level of confidentiality
• Display a sense of motivation and initiative in all assigned duties and tasks

COMMUNICATION

• Interact effectively with the LifeLinc team, management, colleagues, physicians, and other health care professionals

• Work with coworkers to obtain required information on a timely basis and to solve outstanding issues, as needed.
• Promote and contribute positively to the teamwork of the department by assisting coworkers, contributing ideas and problem-solving with colleagues
• Any other duties as assigned

COMPUTER SKILLS

• To perform this job successfully, an individual should have general computer literacy skills and knowledge of Microsoft Office applications.

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to sit; use hands to type and use a computer mouse; and talk or hear. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus.