Provider Enrollment Specialist

🔥 1 hour ago

🏄 California – Remote

🏄 California – Remote

💵 $22 - $28 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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Vituity

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1975

🏥 Healthcare

🤝 B2B

Healthcare • B2B

Vituity is a physician-owned and -led partnership focused on acute care services and clinical operations. The organization positions itself as a leader in acute care innovation and is committed to transforming healthcare with a patient-first approach, uniting clinicians and employees across backgrounds to serve hospitals and patients. The provided text emphasizes clinical leadership, career opportunities, and organizational priorities like privacy and fraud awareness.

📋 Description

• Prepare, submit, and scan approximately 1,000 provider enrollment applications annually for Medicare, Medicaid, Blue Cross, Blue Shield, CAQH, and other payer programs • Manage payer portal access for individual providers • Submit applications to supervisors/managers for audit and work toward an error rate below 10% • Monitor applications to ensure approvals are received and communicated to the billing team before timely filing • Manage daily administrative duties and enhance workflow efficiency • Prioritize requests, manage workload, and execute project plans within deadlines • Work remotely full-time and operate independently with little guidance • Respond to internal and external inquiries on enrollment and contract matters, including payer follow-up every two weeks when needed • Liaise between the billing company, providers, and payer representatives to resolve enrollment issues • Coordinate credentialing for initial, updating, add-on, and maintenance applications • Communicate with providers and departments while maintaining strict confidentiality of provider credentials • Configure Salesforce record types, dashboards, reports, and custom settings • Update Salesforce with billing numbers, contract information, application dates, communications, and issues • Document ongoing and open tasks in databases • Use Salesforce Data Loader for bulk data imports • Use DocuSign to distribute provider enrollment documents, obtain signatures, and follow up with carriers • Deactivate inactive providers from Medicare, Medicaid, and other payers to maintain regulatory compliance • Ensure data integrity and participate in compliance training and development • Review pro forma for new contracts and help protect revenue • Research and resolve payer issues with payers and the billing company • Participate in payer trainings and webinars to implement process improvements • Support research, review, and testing of educational materials for organizational growth

🎯 Requirements

• HS Diploma in combination with relative work experience required • 2-4 years related healthcare experience required • Bachelor’s degree is preferred • 3+ years of related healthcare experience preferred • Knowledge of billing or reimbursement is desired • Provider Enrollment experience is desired • Ability to effectively interact with providers, payer representatives, internal departments, team members, and other stakeholders, both in written and verbal communication • Ability to accomplish tasks thoroughly and accurately • Ability to effectively manage time and organize • Ability to learn billing processes, including timely filing and claims denial reasons • Proficient in Microsoft Office Suite (Word, Excel, Outlook, OneNote, OneDrive, PowerPoint, etc.) • Knowledge of additional technology-based assistance (Teams, SharePoint, etc.) • Knowledge of online Medicare/Medicaid enrollment systems, Identity & Access system, Counsel for Affordable Quality Healthcare system, Medicare enrollment specialties, and National Provider Identifier taxonomies • Knowledge of Medicaid enrollment processes, including revalidations, medical license expirations, deactivations, NPI taxonomy importance, Medicaid managed care data flows, Medicaid billing manuals, state administrative codes, border-state enrollment, and out-of-state enrollment • Knowledge of Salesforce, including Individual Enrollment Contracts, Group Enrollment Contracts, Contracts, Work History, Provider Status, and Clinical Activities objects, dashboards, and reporting • Develop critical thinking skills and professional relationships

🏖️ Benefits

• Monthly wellness events and programs such as yoga, HIIT classes, and more • Trainings to help support and advance your professional growth • Team building activities such as virtual scavenger hunts and holiday celebrations • Flexible work hours • Opportunities to attend Vituity community events including LGBTQ+ History, Día de los Muertos Celebration, Money Management/Money Relationship, and more • Superior health plan options • Dental, Vision, HSA/FSA, Life and AD&D coverage, and more • Top Tier 401(k) retirement savings plans that offers a $1.20 match for every dollar up to 6% plus discretionary profit-sharing contributions (eligible January following 18 months of service) • Generous paid time off starting 3-4 weeks’ annually • Student Loan Refinancing Discounts • Professional and Career Development Program • EAP and travel assistance included • Wellness program • Purpose-driven culture focused on improving the lives of our patients, communities, and employees • Annual corporate Success Sharing bonus program based on the company’s annual performance