Provider Enrollment Specialist - Remote

Overview

Job Highlights

• Submit and process initial enrollment applications and re-enrollment applications to payers in Texas and out of state payers as assigned by leadership.
• Complete reports provided by leadership by assigned deadlines.
• Contribute to the advancement and growth of the department.
• Maintain the accuracy of provider NPPES and CAQH accounts.
• Responsible for following up on outstanding enrollment information and/or paperwork from providers.
• Communicate and work with the billing dept to resolve billing issues.
• Demonstrate exemplary customer service to our payers, providers and other USAP employees.
• Notify billing and appropriate key employees once provider numbers are received.
• Proficiently use the USAP billing system as instructed by leadership.
• Establish and maintain professional working relationships with billing staff and work as a team to resolve billing issues related to enrollment in a timely manner.
• Track and follow up on enrollment or re-enrollment applications with payers until provider enrollment or re-enrollment is completed.
• Populate and prepare enrollment applications for providers.
• Work reports that identify enrollment issues distributed by leadership.
• Meet targeted enrollment deadlines.
• Review provider applications for accuracy and completeness.
• Consistently meet USAP set work standards.
• Assist with roster reconciliation projects with payers.
• Communicate risk to leadership as soon as identified.
• Responsible for provider file maintenance with the payers, including but not limited to provider name changes, license updates, required attestations and any other payer required data.
• Performs other duties as requested.
• Proficiently use the USAP credentialing system as instructed by leadership.
• Maintain the USAP credentialing database as it pertains to enrollment.

Qualifications

• High School graduate or equivalent. AS or B.S. degree in business administration or health care related field is a plus.
• Two years of enrollment experience including Medicare and Medicaid experience.

• Must possess sufficient eye-hand coordination/manual dexterity to operate a keyboard, photocopier, telephone, calculator and other office equipment
• Requires prolonged sitting, some bending, stooping and stretching
• Requires lifting papers and boxes weighing up to 35 pounds occasionally
• Requires dexterity to type at least 35 wpm.
• Required normal range of hearing and eyesight to record, prepare, and communicate appropriate reports and evaluations.

• Work may be stressful at times.
• Work performed in office environment
• Involves frequent contact with colleagues, clinical providers, and hospital medical staff service departments.
• Interaction with others is frequent and often disruptive.

US Anesthesia Partners, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, gender identity, sexual orientation, pregnancy, status as a parent, national origin, age, disability (physical or mental), family medical history or genetic information, political affiliation, military service, or other non-merit based factors.