Provider Enrollment Representative

Overview

The Provider Enrollment Representative supports the Provider Enrollment Department by performing clerical duties, special projects, and general tasks. The role involves receiving notifications from the Clinician Onboarding Liaison (COL), tracking and generating applications, conducting payer research, preparing applications, following up with providers for missing paperwork, reviewing returned packets, generating reports, and supporting multiple projects.

Career Growth Opportunities

A Culture anchored in a strong sense of belonging, benefits (medical/dental/vision) beginning the first of the month following 30 days of employment, 401k (discretionary match), generous PTO, 8 paid holidays, equipment provided for remote roles.

Essentials Duties And Responsibilities

• Receives notifications from the Clinician Onboarding Liaison (COL)
• Tracks and generates applications within 60 days of contract start
• Conducts payer research on the provider
• Adds providers to the group in Teamworks
• Generates and prepares applications to send to provider
• Generates “Application Sent to Provider But Not Returned” reports in Teamworks to follow up with providers for status of outstanding billing paperwork
• Reviews returned packets for accuracy
• Reviews weekly exception reports from management to prioritize critical issues
• Sends updated credentials to the payer
• Primary point of contact for withdrawals; receive and update Teamworks and notify others, if needed
• Generate correct payer paperwork for revalidations/begin re-credentialing process
• CAQH re-attestations

Qualifications / Experience

• Minimum high school diploma or equivalent
• One year of experience in a business setting with fundamental clerical skills, preferably with medical or provider enrollment background
• Meticulous accuracy
• Effective oral and written communication skills
• Proven ability to support multiple projects and work in stressful situations
• Good decision-making and problem-solving skills

Working Level

Full-Time