Provider Enrollment Specialist ( OH, MI, KS)

EyeCare Partners is the nations leading provider of clinically integrated eye care. Our national network of over 300 ophthalmologists and 700 optometrists provides a lifetime of care to our patients with a mission to enhance vision advance eye care and improve lives. Based in St. Louis Missouri over 650 ECP-affiliated practice locations provide care in 18 states and 80 markets providing services that span the eye care continuum. For more information visit.

Job Title:Provider Enrollment Specialist

We are looking to target candidates in these states ONLY: Kansas Michigan Ohio

Pay: $25.00/hr starting pay

Job Summary

The Provider Enrollment Specialistis responsible formanaging high-volume end-to-end provider enrollments for a growing ophthalmology organization. This role owns the full lifecycle of payer enrollmentfrom application preparation and submission through approval and activation ensuring providers are enrolled accurately and efficiently.

The position also supports provider onboarding byinitiatingand completing hospitalprivilegingapplications andmaintainingregular communication with operational leaders. This role is primarily focused on enrollment and payer coordination with limited involvement in credentialing. The Specialist works closely with providers internal teams Medical Staff offices and insurance payers to minimize delays and supporttimelyrevenue cycle activation.

Duties and Responsibilities

• Serve as the primary point of contact for provider enrollment-related inquiries from internal teams and providers.

• Manage full-cycle (end-to-end) provider enrollments including application preparation submission follow-up approval and payer activation.

• Prepare andsubmitinitial enrollment applications with Medicare Medicaid and commercial payers.

• Proactively track and follow up on all pending enrollments to ensuretimelyapprovals and reduce delays in provider participation.

• Maintainaccurateand up-to-date provider enrollment data across all systems and tracking tools.

• Monitor enrollment statuses and provide regular updates to leadership and key stakeholders.

• Maintain strong working relationships with insurance payer representatives toexpediteissue resolution.

• Update andmaintainprovider information in CAQH NPPES and payer portals as it relates to enrollment accuracy.

• Process provider demographic updates including practice locations group

• Initiate complete andsubmitprovider hospitalprivilegingand re-privileging applications ensuring all required documentation isaccurateandtimely.

• Coordinate with hospitals and medical staff offices to trackprivilegingapplicationstatus and approvals.

• Lead andparticipatein biweekly calls with practice leaders providing enrollment status updates addressing issues andaligning ononboarding timelines.

• Maintain internal enrollment andprivilegingrecords ensuringaccuratedata and audit ready.

• Support limited credentialing functions - credentialing paperwork as needed.

• Ensure compliance with Medicare Medicaid and Managed Care payer regulations and requirements.

• Coordinate payer-related aspects of provider onboarding to supporttimelygo-live dates

• Adheres to all safety policies and procedures in performing job duties and responsibilities while supporting a culture of high quality and great customer service.

• Performs other duties that may be necessary or in the best interest of the organization.

Education:

High School Diploma or GED Required

Preferred:Associates Degree(Healthcare Administration Business or related field)

Experience Requirements

• 2years ofprovider enrollmentexperiencein a healthcare setting preferably within a multi-site or specialty practice (ophthalmology experience preferred).

• Demonstrated experience managing end-to-end provider enrollments with Medicare Medicaid and commercial payers.

• Experienceinitiatingand completing hospital privileging applications and coordinating with medical staff offices

Knowledge Skills and Abilities Requirements

• Strong working knowledgeto manage payer enrollment processes timelines and regulatory requirements

• Base understanding of the credentialing processes

• Able to manage high-volume workloads and multiple priorities with minimal supervision.

• Professional in appearance and actions

• Logical and Critical thinking skills for problem solving and analysis.

• Proficiencyin resolving enrollment delays and denials efficiently.

• In-depth knowledge of performance metrics

• Ability to function effectively under stress of conflicting demands on time and attention while successfully meeting deadlines

• High attention to detail professional attitudereliable

• Maintaininghighlevelof accuracy in data entry and documentation.

• Exhibits a positive attitude and is flexible in accepting work assignments and priorities

• Meets attendance and tardiness expectations ability to work overtime ifrequired.

• Management and organizational skills to support the leadership of this function

• Ability to follow or provide verbal & written instructions with sufficient grammar and spelling skills to avoid mistakes or misinterpretations

• Ability to work collaboratively across departments whilemaintainingindividual

• Interpersonal skills to support customer service functional andteammatesupport need

• Able to communicate effectively in English both verbally and in writing

• Ability to work collaboratively across departments.

• Ability for intermediate problem solving including mathematics

• Ability to learnnew technologiesand systems to track and report on enrollment status using spreadsheets databases or enrollment software

• Intermediate computer operation

• Proficiencywith Microsoft Excel WordPowerPointand Outlook

• Specialty knowledge of systems relating to job function

• CAQH NPPES PECOS andPayer-specific enrollment portals

• Preferred: Data management system (Availity)

• Knowledge of state and federal regulations for this position; general understanding of HIPAA guidelines

Location:

Work takes place in a remote work environment. Travel to other locations may be necessary to fulfill the essential duties and responsibilities of the job. Thus those needing to travel for work must have access to dependable transportation and their driving record must meet company liability carrier standards.

Please do not contact the office directly only resumes submitted through this website will be considered.

If you need assistance with this application please contact

EyeCare Partners is an equal opportunity/affirmative action employer. All applicants will be considered foremploymentwithout attention to race color religion sex sexual orientation gender identity national origin veteran or disability status.

Job descriptions are intended to be accurate reflections of those principal job elements essential for making fair pay decisions about jobs. Nothing in this job description restricts management right to assign or reassign duties and responsibilities to this job at any time.