Senior Enrollment Specialist

Job not on LinkedIn

🔥 0 minutes ago

🍂 Massachusetts – Remote

🍂 Massachusetts – Remote

💵 $25 - $38 / hour

⏰ Full Time

🟠 Senior

👻 Ghost score 0%

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Beth Israel Lahey Health

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

Beth Israel Lahey Health is a comprehensive healthcare system providing a wide range of medical services and care options to communities in Massachusetts and New Hampshire. With a network of 14 hospitals, including community hospitals and specialized centers for orthopedic and behavioral health care, they offer personalized care for all health needs. Their services include emergency care, primary care, urgent care, pharmacy services, home care, and more. Dedicated to improving community health and well-being, Beth Israel Lahey Health is committed to research, education, and providing extraordinary care through its 39,000 team members.

📋 Description

• Complete enrollment and health plan recredentialing applications under the direction of the Manager, Provider Enrollment • Maintain the physician database and serve as a resource to providers, practice staff, BIDCO staff, and health plan representatives • Facilitate timely enrollment of new providers and existing providers in newly contracted health plans • Compile confidential data and accurate health plan application packets • Review returned applications for accuracy and completeness before submission • Perform provider recredentialing every two years and track applications through completion • Input and maintain enrollment information and ongoing changes in the provider database • Communicate with health plans, clinicians, and practice staff regarding provider participation and status • Develop reporting mechanisms to keep providers and administrators informed of health plan status • Investigate and resolve enrollment problems affecting billing and reimbursement • Assist with applications for new group entities joining BIDCO and coordinate required documentation • Coordinate with local community hospitals regarding hospital privileges and relevant documents • Facilitate the delegated credentialing process with affiliated Professional Staff Affairs offices

🎯 Requirements

• High School diploma or GED required • Bachelor's degree preferred • 1-3 years related work experience required • Provider Enrollment experience strongly preferred • Advanced skills with Microsoft applications, including Outlook, Word, Excel, PowerPoint or Access, and other web-based applications • Ability to produce complex documents, perform analysis, and maintain databases • Knowledge of Medicare, Medicaid, health plan credentialing, recredentialing and enrollment processes preferred • Knowledge of licensure requirements and regulations of relevant medical boards preferred • Ability to communicate complex information in English in written and verbal formats • Ability to make moderately complex decisions and recommendations • Ability to analyze and solve varied problems • Ability to work independently within general guidelines and seek assistance when needed • Ability to work collaboratively in small teams • Ability to provide high-level customer service and staff training • Ability to sustain concentrated effort for up to 4 hours without a break • Ability to work sedentarily, including constant sitting and keyboard use, with frequent fine manipulation • Must be vaccinated against influenza as a condition of employment

🏖️ Benefits

• Influenza vaccination required as a condition of employment • Potential additional compensation through shift differentials, call pay, premium pay, and overtime pay, as applicable