Provider Enrollment Associate

Description:

Description

The Provider Enrollment Associate facilitates the application from a new medical provider through all stages of enrollment in order to enroll the medical provider with commercial and/or government insurance companies as well as the facilities. The Associate is also responsible for updating medical provider information in both internal software and with external insurance companies. In addition to data entry, the Associate also maintains copies of licensure, certificates, and other documents necessary for the enrollment process, maintains provider Council for Affordable Quality Healthcare (CAQH) profiles, and conducts verification of all data, ensuring accuracy and timely entry of information. The Associate shares essential updates with medical providers and the internal team as necessary.


High proficiency skills with computers is a must and must be able to retain training especially with software. Willing to train the right person.

  • Assembles and maintains current and accurate data for all practices and providers.
  • Ensures timely processing of all credentialing requests.
  • Coordinates with providers to obtain signatures and documents necessary for completion of process.
  • Completes practice and provider credentialing and re-credentialing applications; monitors applications and follows-up as needed.
  • Ensures practice demographic and addresses are current with health plans, agencies and other entities.
  • Ensures Billing Team is aware of when a provider is enrolled with insurances via email.
  • Assists Billing Team with troubleshooting accounts with contract related issues.
  • Maintains Credentialing Software of which insurance practice and providers are credentialed with.
  • Create and keep up with all provider's Council for Affordable Quality Healthcare (CAQH) profiles, attesting quarterly.
  • Order correct malpractice insurance, maintaining certificate information current as providers are hired or resigned.
. Requirements:

General Qualifications, Skills and Abilities Required:

  • High School Diploma or GED
  • Strong communication skills as you will be speaking with payers, facilities, medical billing staff, and/or clients on a weekly basis utilizing a telephone
  • Ability to work independently in a fast-paced environment while remaining calm and professional
  • Must be able to multi-task
  • Proficiency in Microsoft Office
  • Thoroughness, attention to detail

Desired Qualifications and Skills:

  • PECOS Experience
  • CAQH Experience
  • ADOBE and DocuSign Experience
  • Strong Contracting and Negotiation or provider agreements
  • General delegation credentialing knowledge

PM20



Posted
06/11/2021
Type
Full time
Salary Range
$20,000.00 - 33,000.00
per Year
Salary range estimated by
Location
Tampa, FL 33646, US