Provider Enrollment Specialist (Temporary for 9-12 Months) - Remote - Nationwide

About the role

Vituity is seeking a Provider Enrollment Specialist to join our team. As part of a larger team dedicated to transforming healthcare, you will play a crucial role in ensuring smooth provider enrollment processes.

Responsibilities

• Prepare, submit, and scan approximately 1,000 provider enrollment applications per year for Medicare, Medicaid, Blue Cross, Blue Shield, CAQH and other payer programs as needed.
• Work towards an error rate of less than 10% by submitting all applications to supervisor/manager for audit.
• Maintain efficient workflows by managing daily administrative duties, prioritizing requests, and managing time and workload to execute project plans within given deadlines.
• Respond to internal and external inquiries on routine enrollment and contract matters, including follow-up with payers on applications as frequently as every 2 weeks.
• Serve as a liaison between billing company, providers, and payer representatives to resolve all provider enrollment issues with assistance from supervisor/manager.
• Coordinate the credentialing process with an on-site administrator as needed to complete credentialing for initial, updating, and add-on applications and maintenance processes.
• Communicate with providers and other departments to update as needed, clarify carrier information requirements, and maintain strict confidentiality for all matters pertaining to provider credentials.
• Manage Salesforce configuration changes, update records with billing numbers, contract information, submission dates of applications, and notation of any communications or problems requiring attention.
• Use DocuSign to send out PE documents, obtain required client signatures, and follow up with carriers on documentation submitted.
• Deactivate inactive providers from Medicare, Medicaid, and other payers to remain compliant with federal and state regulations.
• Ensure data integrity and participate in trainings and development to mitigate compliance risk with state and federal regulations.
• Assist in reviewing proforma for new contracts and assist in protecting revenue.
• Research numerous payer issues and work to resolve them quickly and effectively with oversight from supervisor/manager with the goal of losing less than $100K in revenue per year.
• Contribute and assist with implementation of process improvement ideas by participating in payer trainings and webinars as needed.
• Support research, review, and testing of educational materials for organization growth.

Requirements

• High School Diploma in combination with relative work experience required.
• 2-4 years related healthcare experience required.
• Bachelor’s degree is preferred.
• 3+ years of related healthcare experience preferred.
• Knowledge of billing or reimbursement is desired.
• Provider Enrollment experience is desired.
• Ability to effectively interact with providers, payer representatives, internal departments, team members, and other stakeholders, both in written and verbal communication.
• Ability to accomplish tasks thoroughly and accurately.
• Ability to effectively manage time and organize.
• Knowledge of Microsoft Office Suite (Word, Excel, Outlook, OneNote, OneDrive, PowerPoint, etc.).
• Knowledge of additional technology-based assistance (Teams, SharePoint, etc.).
• Knowledge of online Medicare/Medicaid enrollment systems, Identity & Access system, Counsel for Affordable Quality Healthcare system, Medicare enrollment specialties, and National Provider Identifier taxonomies.
• Knowledge of Salesforce (including Individual Enrollment Contracts, Group Enrollment Contracts, Contracts, Work History, Provider Status, and Clinical Activities objects), and utilizing dashboards and reporting to develop internal preferences for ongoing workload management.
• Develop critical thinking skills and professional relationships.

Qualifications

• Comfortable with working remotely full-time.
• Ability to work independently with little guidance and adapt.

Skills

• Microsoft Office Suite proficiency.
• Knowledge of online Medicare/Medicaid enrollment systems.
• Knowledge of Salesforce.
• Ability to research and resolve payer issues quickly and effectively.
• Strong communication and interpersonal skills.
• Ability to prioritize tasks and manage time efficiently.

Benefits

• Superior health plan options.
• Dental, Vision, HSA/FSA, Life and AD&D coverage.
• Top Tier 401(k) retirement savings plans with a $1.20 match for every dollar up to 6% plus discretionary profit-sharing contributions.
• Generous paid time off starting 3-4 weeks’ annually.
• Student Loan Refinancing Discounts.
• Professional and Career Development Program.
• EAP and travel assistance included.
• Wellness program.
• Purpose-driven culture focused on improving the lives of our patients, communities, and employees.

Pay

The base salary range for this position is $22.90 - $28.63, exclusive of fringe benefits or potential bonuses. This position is also eligible to participate in our annual corporate Success Sharing bonus program, which is based on the company’s annual performance. Final base salary compensation will be determined based on factors such as skills, education, and/or experience. Vituity is committed to complying with all applicable national, state, and local laws pertaining to nondiscrimination and equal opportunity.

Schedule

Full-time remote position.