Provider Enrollment Specialist
Posted 20ds ago
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Job Description
Provider Enrollment Specialist enrolling Bridgeview Eye Partners’ eye-care providers and facilities with government, managed care, and commercial payers. Maintaining credentialing records and resolving enrollment issues.
Responsibilities:
- Manage provider and facility payer enrollment applications from preparation through completion, ensuring accuracy and timely submission
- Collect, review, and verify documentation required for provider and facility enrollments
- Complete payer enrollment, hospital credentialing, professional licensure, and related applications in accordance with payer requirements and government regulations
- Maintain accurate information across credentialing and enrollment databases and payer portals, including Availity, CAQH, NaviNet, NPPES, and PECOS
- Monitor pending applications, identify deficiencies, and resolve issues to keep enrollments on track
- Research and resolve provider and facility enrollment issues with internal teams and external payer contacts
- Monitor revalidations, license renewals, and other required updates to ensure compliance and enrollment
- Support the Credentialing Manager with new facilities, locations, and providers as the organization expands into new markets
- Escalate complex or unresolved credentialing and enrollment issues appropriately
- Provide responsive, professional support to internal stakeholders throughout the enrollment process
- Collaborate with teams throughout the organization, payers, and regulatory systems
Requirements:
- High school diploma or equivalent
- At least 3 years of healthcare experience in payer relations, market access, managed care, provider enrollment, credentialing, or a related field
- Strong organizational skills and exceptional attention to detail
- Proficiency with Microsoft Office, including Outlook, Teams, Word, and Excel
- Ability to manage multiple priorities, meet deadlines, and maintain accuracy in a highly detail-oriented environment
- Strong communication and customer service skills
- Demonstrated accountability, professionalism, and integrity
- Experience with MedTrainer Credentialing software preferred
- Knowledge of managed care contracts and payer requirements preferred
Benefits:
- Competitive hourly wage
- Paid holidays + 2 Floating Holidays
- Approximately 10 days of PTO within first year
- Benefits including medical, dental, & vision
- 401(k)
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