Enrollment Specialist
Enrollment Specialist
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Salary Not Disclosed
1 Vacancy
Job Description
The Enrollment Specialist will be the primary contact for the Enrollment Department for all Privia independent providers and responsible for all aspects of managing the payer enrollment process for this market.
- Enrolls providers new to Privia with all commercial health plans specific to the market.
- Enrolls providers new to Privia with both Medicaid and Medicare.
- Data enters add to roster date in CredentialStream.
- Data enters submitted and mailed dates in CredentialStream.
- Data enters effective date in CredentialStream.
- Reviews data in provider record specifically taxonomy and specialty and ensures it is correct prior to submitting applications.
- Performs follow up with health plans 30 days after submission and then biweekly thereafter until the provider is PAR.
- Escalates known issues to manager for assistance.
- Collaborates with credentialing team regularly to ensure that there is an awareness of all new providers who are onboarding.
- Attends RCM and payer calls as needed as well as any other internal stakeholder meeting that may involve their market as needed.
- Other duties as assigned.
Qualifications :
- 2 years experience in payer enrollment function
- Delegated and Non Delegated payer enrollment experience (not required but preferred)
- Experience with RCM Enrollment claim resolution
- Verity or other credentialing experience preferred
- Medicare/Medicaid payer experience required
- Demonstrated skills in problem solving and analysis and resolution
- Must be able to function independently possess demonstrated flexibility in multiple project management
- Must comply with HIPAA rules and regulations
- An individual with the ability to communicate appropriately and effectively with providers; including sensitive and confidential information
- An individual who is passionate about playing a key role in changing the current healthcare environment
- High level of attention to detail with exceptional organizational skills
- Exercise independent judgment
- Ability to problem solve and explore all options and to use available resources to find new and effective solutions
The salary range for this role is $45000.00 $55000.00 in base pay and exclusive of any bonuses or benefits (medical dental vision life and pet insurance 401K paid time off and other wellness programs). This role is also eligible for an annual bonus targeted at 10%.The base pay offered will be determined based on relevant factors such as experience education and geographic location.
Additional Information :
All your information will be kept confidential according to EEO guidelines.
Technical Requirements (for remote workers only not applicable for onsite/in office work):
In order to successfully work remotely supporting our patients and providers we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests like This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.
Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. Privia is a better company when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age color national origin physical or mental (dis)ability race religion gender sex gender identity and/or expression marital status veteran status or any other characteristic protected by federal state or local law.
Remote Work :
Yes
Employment Type :
Fulltime
Employment Type
Remote
Company Industry
Key Skills
- Sales Experience
- Crane
- Customer Service
- Communication skills
- Heavy Equipment Operation
- Microsoft Word
- Case Management
- OSHA
- Team Management
- Catheterization
- Microsoft Outlook Calendar
- EHS
