Provider Enrollment Specialist

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🔥 0 minutes ago

🐊 Florida – Remote

🐊 Florida – Remote

💵 $21 - $24 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

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Advanced Recovery Systems, LLC

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2014

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

Advanced Recovery Systems, LLC is presented on its website as a company that assists with health insurance matters and related administrative support. The site text states "Health insurance is changing, but your health can’t wait. Call (352) 771-2700 and let us handle it for you," indicating the company provides help navigating insurance or managing insurance-related tasks for callers. The website also includes cookie/consent management and location search features, suggesting a consumer-facing service with multiple locations. Limited public text is available, so this description is conservative and based primarily on the provided site excerpt.

📋 Description

• Assist the organization with payer contracting efforts, including provider applications, contract analysis, negotiations, and credentialing of facilities and medical/clinical providers • Ensure the contracting and credentialing department works successfully with Sales/Marketing, Finance, Legal, Compliance, Medical, and Operations • Ensure all medical and clinical staff are appropriately credentialed with all payers and payer requirements • Assist the credential manager in identifying new-hire needs and aligning credentials with payer needs • Review and prepare payer credentialing and recredentialing applications for completeness and accuracy • Work with providers and the credentialing department to obtain required information • Collaborate with Business Development, Marketing, and Finance to identify managed-care contract growth opportunities • Evaluate and analyze contract proposals and work with the SVP to negotiate contract rates • Serve as direct contact and liaison between payers and ARS facilities regarding contracts, addendums, and credentialing needs • Conduct quality-control audits of files and remediate and prevent future errors • Prepare reports for internal and external use • Work with the billing department to address non-participating or disenrolled providers

🎯 Requirements

• Minimum of High School Diploma or Equivalent • Minimum three (3) years’ experience in provider or payer contracting and credentialing • Knowledge of Hospital and/or Behavioral Contracting and Reimbursement • Knowledge of CAQH requirements and profiles • Experience with credentialing and re-credentialing applications for facilities and payer contracting • Strong Computer Knowledge • Must use a personal computer meeting the company's software and virus security standards • Windows 11 with the latest Windows update installed; Chromebooks and Apple computers are not compatible • Up-to-date antivirus software • Working camera and microphone • Must live in the US and reside in the Eastern or Central Time Zone

🏖️ Benefits

• Health, Vision, Dental, Employer Matched 401(k) • STD, LTD, and Employer Paid Term Life Policy - up to $50k • Employer Matched HSA – up to $1500 a year company contribution • Employee Wellness Program – reduce employee premiums $40/mo • Free MDLive telehealth benefit • Paid Time Off - Vacation/Personal/Holiday/Sick • Employee Referral Bonus • ARS does offer some reimbursement for remote office equipment • 401(k) • paid time off plan • medical, dental, vision