Provider Enrollment Specialist
Changing Lives Everyday... More people trust their eye surgery to the doctors of Barnet Dulaney Perkins Eye Center than anywhere else in Arizona. Over the last 35 years, we have become one of the largest Cataract, Retina and Glaucoma practices in the nation, providing state-of-the-art surgical and medical ophthalmologic care through-out the state of Arizona. In addition, we are considered a premier provider for vision correction options such as LASIK and the ICL Implantable Contact Lens. A career in the Eye Care industry could provide you with long-term employment stability. Proven within our organization, many employees have been here for 10, 20 and some even over 30 years.
We are seeking candidates to fill the position of Provider Enrollment Specialist to join our credentialing team. The ideal candidate should be able to display a positive attitude, and constructively contribute to work team.
This position is responsible for the overall administration of the provider enrollment process for assigned new and existing providers as well as assuring new start-ups are being effectively managed. Position is also responsible for obtaining and maintaining information essential to complete the credentialing/re-credentialing process.
Works closely with and reports to the Director of Credentialing & Contracts.
These are the kinds of things you can expect to do on a daily basis if chosen for the Provider Enrollment Specialist role:
- Preparing and submitting enrollment applications for practitioners/group practices and facilities.
- Initiate and manage new enrollments until providers are enrolled with all assigned payers.
- Following up on the status of enrollment applications as well as maintaining all updated needed using Smart Sheets.
- Using Smart Sheets, keeping detailed log of all pending and completed tasks. Attention to detail is a key aspect of this position.
- Maintain/Update/Communicate enrollment status reports and updates on regular basis.
- Maintain/update Wybtrak/CAQH and other provider portals on regular basis.
- Maintains managed care insurance paperless files for assigned practitioners.
- Frequent contact with practitioners, insurance representatives and other provider staff for compilation of provider data.
- Comply with NCQA, Medicare and Medicaid standards, department procedures and guidelines.
- Maintains strict confidentiality, adheres to all HIPAA Guidelines/Regulations.
- Familiar with Medicare, Medicaid, commercial fee schedules; assist Director in updating fee schedules for updates to Next Gen EPM.
- Works effectively and proactively to resolve issues.
- Performs all other duties as assigned by Director.
Skills / Requirements
Education: High School Diploma or equivalent. 2 – 3 years’ experience in Provider Enrollment and Credentialing fields is required for this position.
- Experience in provider enrollment for various payers preferred.
- Knowledge of provider enrollment processes and requirements for commercial insurance companies, CMS Federal and State Guidelines related to enrollment policies.
- Attentive to detail and accuracy.
- Excellent customer service skills
- Proficiency in MS applications and Internet Usage
- Excellent Communication Skills
- Able to work under pressure and meet deadlines
- Strong organizational skills and ability to pay attention to detail
- Ability to work independently and prioritize assigned duties within given time frames.
- Ability to establish and maintain effective working relationships with insurance representatives, providers and coworkers.
BDPEC offers a very generous and comprehensive total rewards package to include company medical, dental and vision insurance for employees, up to 19 days of paid time off per year, a 401(k), flexible spending account plan, and training opportunities.
To learn more about Barnet Dulaney Perkins Eye Center and our career opportunities, please visit our website at www.goodeyes.com.
Pre-employment drug and background screening required prior to employment.
EEO/AA (W/M/Vets/Disability) Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin. We are also an equal opportunity employer of individuals with disabilities and protected veterans. Please view Equal Employment Opportunity Posters provided by OFCCP; http://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm .
Job Status: Full Time
Job Reference #: Phoenix