Provider Enrollment Associate

This is a fully remote position, open to applicants in United States.

📋 Description

• Supervise tasks related to credentialing, licensing, and payer enrollment.

• Serve as a liaison to providers and vendors to gather necessary information for credentialing, license verification, and payer enrollment.

• Offer expertise in credentialing and enrollment for the organization.

• Enhance third-party workers' knowledge through routine meetings and coaching sessions.

• Keep accurate provider databases that include payer enrollment, licensure, and malpractice information.

• Report any delays in the credentialing and enrollment processes.

• Investigate and self-report issues, formulate solutions, and identify processes for risk mitigation.

• Aid in resolving claim denials related to payer enrollment.

• Monitor processes and outcomes to ensure that credentialing, licensure, and enrollment KPIs are achieved.

• Provide insights to Payer Contracting to improve payer-specific requirements and decrease enrollment timelines.

• Acquire and document regulations and rules for new states.

• Perform additional duties as assigned.

⛳️ Requirements

• An associate degree or equivalent experience is required; a Bachelor’s degree is preferred.

• 3-5 years of experience in provider enrollment.

• Comprehensive understanding of credentialing, licensure, and payer enrollment requirements.

• Proficient in using PECOS, CAQH, Availity, and other payer portals.

• Familiarity with EDI, ERA, and EFT enrollments.

• Skilled in MS Excel and PowerPoint.

• Exceptional verbal and written communication abilities.

• Customer service experience is preferred.

🏝️ Benefits

• Competitive compensation.

• Medical, dental, and vision benefits.

• Life insurance.

• Short and long-term disability coverage.

• Paid vacation and holidays.

• 401k plan with matching contributions.

• Access to state-of-the-art technology.

• Flexible scheduling options.

• Opportunities for in-person and virtual patient visits.

• Comprehensive administrative support (front office, accounting, finance, payroll, HR, etc.).

• Opportunities for professional development.

• Support and leadership within a clinical community.