Healthcare Provider Enrollment Expert

4 days ago

Pasig, National Capital Region, Philippines beBeeEnroller Full time $54,000 - $74,000
Job Overview

The Provider Enrollment Specialist plays a pivotal role in the credentialing and enrollment process, ensuring seamless integration with our team.

Key Responsibilities:
  • Communicates effectively with providers to clarify enrollment procedures and obtain necessary documentation.
  • Maintains accurate and up-to-date provider information within our system, guaranteeing precision and completeness.
  • Facilitates timely enrollment by establishing and maintaining data entry in CAQH, streamlining the process for all stakeholders.
  • Prepares and submits provider enrollment applications for initial enrollments and re-credentialing processes.
  • Verifies provider and group information with insurance companies, including addresses, contracted plans, and provider ID numbers.
  • Cultivates efficient enrollment and termination processes for all providers, fostering a collaborative environment.
  • Handles enrollment with Medicare, Medicaid, and commercial insurances, showcasing adaptability and expertise.
  • Contributes to departmental process improvements through collaboration and feedback, driving excellence and innovation.
  • Maintains accurate records and completes actions and follow-up tasks related to provider enrollment, exemplifying exceptional organizational skills.
Requirements

To be successful in this role, candidates must possess:

  • A high school diploma or equivalent as a minimum requirement.
  • At least two years of experience in provider enrollment, demonstrating a deep understanding of the field.
  • Proficiency in Microsoft Word, Outlook, Excel, and CAQH, highlighting technical prowess.
  • Billing knowledge and experience are highly desirable, showcasing versatility and adaptability.
  • Exceptional verbal and written communication skills, enabling effective collaboration and stakeholder engagement.

This role demands strong organizational and time management skills, as well as attention to detail and the ability to handle multiple priorities. The ideal candidate will possess a collaborative mindset and excel in a team-based environment.

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