CORP H&W/PROVIDER ENROLLMENT SPECIALIST

JOB DESCRIPTION

Responsible for obtaining, tracking, and coordinating required enrollment and reenrollment information, as applicable, from Nurse Practitioners (NP), Physician Assistants (PA), Collaborating Physicians (CP), Licensed Practical Nurses (LPN), and Registered Nurses (RN) and other licensed medical professionals whose services are potentially reimbursable from payors or required by law. Responsible for submitting necessary information to the required organizations, agencies, affiliates, and third-party payors. Demonstrate the company's core values of respect, honesty, integrity, diversity, inclusion and safety.

RESPONSIBILITIES

• Obtain and submit the required information to enroll and reenroll healthcare providers
• Responsible for facilitating the completion of all payor applications
• Maintain information in the enrollment database for NP, PA, CP, and PCT licenses provider numbers related requirements
• Track enrollment status with each required organization, agency, affiliate, and third-party payor
• Establish and maintain a strong working relationship with Company clinicians, third-party payors, medical professional boards, and State and Federal agencies
• Track provider enrollment status on a continuous basis, while communicating as necessary with other Company departments
• Must be able to perform the essential functions of this position with or without reasonable accommodation.

• Payor credentialing process knowledge at a high level is required
• Good working knowledge of MS Office Suite
• Excellent organizational skills and attention to detail
• Excellent written and oral communication skills

• 1-year of payor credentialing experience
• Experience setting up new group practices and experience in a hospital credentialing or provider enrollment department
• Experience with large third party payors (commercial and government)