Senior Enrollment Specialist

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

📋 Description

• Execute enrollment and health plan recredentialing applications under the guidance of the Provider Enrollment Manager.

• Maintain the physician database and act as a resource for providers, practice personnel, BIDCO staff, and health plan representatives.

• Ensure the prompt enrollment of new providers and existing providers in newly contracted health plans.

• Compile confidential data and create accurate health plan application packets.

• Review submitted applications for accuracy and completeness prior to submission.

• Conduct provider recredentialing every two years and monitor applications until completion.

• Enter and update enrollment information and ongoing changes in the provider database.

• Communicate with health plans, clinicians, and practice staff regarding provider participation and status updates.

• Develop reporting systems to keep providers and administrators informed about health plan status.

• Investigate and address enrollment issues affecting billing and reimbursement.

• Assist with applications for new group entities joining BIDCO and coordinate necessary documentation.

• Collaborate with local community hospitals concerning hospital privileges and related documents.

• Facilitate the delegated credentialing process with affiliated Professional Staff Affairs offices.

⛳️ Requirements

• High School diploma or GED is required.

• A Bachelor's degree is preferred.

• 1-3 years of relevant work experience is required.

• Experience in Provider Enrollment is strongly preferred.

• Proficient skills in Microsoft applications, including Outlook, Word, Excel, PowerPoint, or Access, as well as other web-based applications.

• Capability to produce complex documents, conduct analyses, and maintain databases.

• Preferred knowledge of Medicare, Medicaid, health plan credentialing, recredentialing, and enrollment procedures.

• Familiarity with licensure requirements and regulations of relevant medical boards is preferred.

• Ability to convey complex information in English through both written and verbal communication.

• Capacity to make moderately complex decisions and recommendations.

• Proficiency in analyzing and resolving varied issues.

• Ability to work independently within general guidelines while seeking assistance as necessary.

• Proficient in collaborating within small teams.

• Ability to deliver high-level customer service and staff training.

• Capacity to maintain focused effort for up to 4 hours continuously.

• Capability to work sedentarily, including frequent sitting and keyboard use, along with fine manipulation.

• Must be vaccinated against influenza as a condition of employment.

🏝️ Benefits

• Influenza vaccination is required as a condition of employment.

• Potential for additional compensation through shift differentials, call pay, premium pay, and overtime pay, as applicable.