Provider Enrollment Specialist

🔥 4 hours ago

🗽 New York – Remote

🗽 New York – Remote

💵 $24 - $28 / hour

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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TAG - The Aspen Group

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

TAG - The Aspen Group is a company focused on revolutionizing the healthcare sector by enhancing patient care and experience in various areas, including dentistry and walk-in medical care. The group supports its brands to break down barriers in dental care, foster professional growth, and make significant contributions to the healthcare industry. With a commitment to empowering its teams, The Aspen Group aims to restore smiles and confidence, making healthcare accessible and compassionate.

📋 Description

• Prepare, submit and track payer enrollment applications for new providers and existing provider changes • Maintain accurate records of enrollment activities in the credentialing system • Communicate with insurance companies, healthcare providers and internal departments to ensure efficient application processing • Monitor enrollment status and follow up with payers to resolve delays or issues • Update provider demographic and practice information with contract payers • Maintain recredentialing timelines and requirements to prevent enrollment lapses • Collaborate with Field Support, Operations and Revenue Cycle Management teams to resolve escalated enrollment or credentialing issues • Research and resolve out-of-network claims issues by investigating provider participation status and enrollment effective dates • Coordinate temporary provider enrollments and complete required documentation, linkage and payer updates • Collaborate with RCM on provider enrollment status and provide reports as needed • Generate and maintain enrollment status reports • Support audits and perform other duties as assigned • Report to the Enrollment Manager

🎯 Requirements

• High school diploma or equivalent required • Associate or Bachelor’s degree preferred • 1–3 years of experience in payor enrollment • Working knowledge of commercial payors and government payor requirements • Proficient in Microsoft Office and credentialing software including CAQH and Availity • Strong attention to detail, organization and follow-up skills • Excellent communication and customer service abilities interacting with internal teammates and external clients • Detail oriented, with strong analytical and problem-solving skills • Experience working with multi-specialty large group practices preferred; dentistry is a plus • Knowledge of revenue cycle and billing processes preferred • Familiarity with NPI and file provider management preferred

🏖️ Benefits

• Paid time off • Health insurance • Dental insurance • Vision insurance • 401(k) savings plan with match