Provider Enrollment Specialist

🔥 0 minutes ago

🗽 New York – Remote

🗽 New York – Remote

💵 $24 - $26 / hour

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

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TAG - The Aspen Group

WebsiteLinkedInAll Job Openings

10,000+ employees

⚕️ Healthcare Insurance

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 all enrollment activities in the credentialing system. • Communicate with insurance companies, healthcare providers and internal departments to ensure applications are processed efficiently. • Monitor enrollment status and follow up with payers to resolve delays or issues. • Update provider demographic and practice information with all contract payers as needed. • Ensure recredentialing timelines and requirements are maintained so providers enrollment status remains intact with no lapses. • Work closely with Field Support, Operations, Revenue Cycle Management (RCM) team to resolve any escalated enrollment or credentialing issues in a timely manner. • Research and resolve out of network claims issues by investigating provider participation status and effective dates of enrollment. • Coordinate temporary provider enrollments and ensure all necessary documentation, linkage and payer updates are completed. • Collaborate closely with RCM on status of provider enrollments including providing reports submission as needed. • Generate and maintain enrollment status reports. • Support audits, and other duties as assigned.

🎯 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 but not limited to CAQH, 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 level of analytical and problem-solving skills.

🏖️ Benefits

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