Enrollment Specialist
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Job Location:
San Antonio, TX - USA
Monthly Salary:
Not Disclosed
Posted on:
Yesterday
Vacancies:
1 Vacancy
Job Summary
Enrollment Specialists are responsible for maintaining the Credentialing portal and filling the gaps in the payer enrollment process at the individual group and facility levels.
Responsibilities:
- Acts as a liaison between Deer Oaks clinicians and the credentialing partner
- Enrolls clinicians to obtain an NPI number if the clinicians do not have one already
- Assists in creating CAQH ID/Account if needed by the clinicians
- Populates portal with SSN/CAQH ID/Last name to kick off documentation gathering
- Works with the clinicians to gather and upload missing documentation within the credentialing portal
- Establishes surrogacy relationship with clinicians and the credentialing partner
- Submits requests for enrollment at the individual group and facility level for all payers
- Obtains additional documents as needed during enrollment including the facilitation of site inspections if required
- EHR enrollment support (PointClickCare)
- Adds or changes submissions based on new or changed plans and informs the credentialing partner
- Fulfills facility credentialing requests from facilities providing CV license COI etc.
- Updates the clinicians taxonomy with NPPES/NPI when needed and communicates changes to the Director
- Updates name changes or records license certification updates
- Tracks collaborative agreements and supervision in the portal
- Executes service location reports for payers including roster submissions
- Assists with the tracking of CEUs
- Adds and maintains locations and facilities in the portal
- Monitors dashboard to track progress of enrollments and provide any information needed
- Monitors expiration dates and keeps all enrollments individual or group active
- Manages Medicaid portals including linking all places of service to the group when required and submitting license renewals to maintain Medicaid enrollment.
Qualifications:
High school diploma or equivalent
Associates degree preferred
2 years of relevant healthcare/provider credentialing experience
Experience with full cycle enrollments in Medicare Medicaid and Managed Care Plans
Knowledgeable of assigned states credentialing and payer requirements
Experience with state licensure enrollments
Ability to multi-task and prioritize work to meet deadlines
Excellent verbal and written communication skills
Positive customer service attitude
Ability to research and analyze data and work independently with minimal supervision
Required Experience:
IC
Key Skills
- Sales Experience
- Crane
- Customer Service
- Communication skills
- Heavy Equipment Operation
- Microsoft Word
- Case Management
- OSHA
- Team Management
- Catheterization
- Microsoft Outlook Calendar
- EHS
About Company
Click here to learn more about Deer Oaks, the nation’s leading long-term care focused behavioral health provider.
