Provider Enrollment Specialist

TeleSpecialists is transforming healthcare delivery as the nation's largest and fastest-growing digital healthcare leader. By providing expert neurological and psychiatric care directly to over 400 hospitals and health systems across the country, we pioneer solutions that make quality healthcare easily accessible. Join a team where your passion meets our purpose in a collaborative and entrepreneurial environment, reshaping the future of patient care.

Benefits

• Medical, Dental, and Vision benefits
• Tuition Reimbursement
• 401k match
• Paid Vacation
• Leadership Training Classes
• Mentorship Program
• Career advancement opportunities in a rapidly growing company

About the Role

The Payer Enrollment Team Member assists facilities with enrolling TeleSpecialists providers with Medicare, state Medicaid, and commercial insurance carriers. This role maintains current CAQH, PECOS, and State Medicaid profiles and ensures management is aware of any issues with provider profiles.

Responsibilities

• Complete initial, reassignment, and re-validation applications with Medicare for facilities and providers.
• Complete initial, reassignment, and re-validation applications with various state Medicaid programs for facilities and providers.
• Ensure physician Medicare re-validation applications for Commercial insurance networks are completed on time.
• Maintain PECOS portal for providers, including approval of facilities and updating demographic information.
• Manage and maintain NPPES portal for providers.
• Create, update, and maintain CAQH profiles for providers.
• Manage Practice Manager CAQH profile for all providers and facilities.
• Manage password updates for various enrollment portals, including but not limited to CAQH, Medicare, and Medicaid.
• Update and maintain MD Staff with the progress of all activities.
• Complete facility payer enrollment paperwork for providers and return to the facility in a timely manner.
• Manage Availity portal for various insurance networks.

Requirements

• Payer Enrollment experience required.
• Credentialing software experience required; MD Staff preferred.
• Experience with Joint Commission or National Committee for Quality Assurance preferred.

Physical Requirements

• Must be able to remain in a stationary position (sitting or standing) for prolonged periods, often up to 75% of the workday.
• Needs to occasionally move about inside the office to access file cabinets, office machinery, or shared workspaces.
• Constantly operates a computer and other office productivity machinery, such as a calculator, copy machine, and printer.
• Must be able to exchange accurate information with clients and co-workers in person, over the phone, and via digital platforms.
• Occasionally moves or transports office supplies, files, or equipment weighing up to 25 pounds.
• Occasionally positions self to maintain files in cabinets or access equipment stored in low or high areas.
• Requires close visual acuity to perform activities such as preparing and analyzing data, transcribing, and viewing a computer monitor for extended periods.

Travel Requirements: Minimal (0%-5%)