Provider Enrollment Specialist

Atlanta, GA 30342

Posted: 03/26/2019 Industry: Administrative Job Number: 14786 Pay Rate: 17.00

Our client, the corporate office of a national urgent clinic, is hiring for a Provider Enrollment Specialist.

Location: Atlanta, near Perimeter Mall

Pay Rate: $17-$18/hour

Employment Type: Contract to possible hire

Start Date: ASAP

Schedule: Open to discuss

Job Summary

The Provider Enrollment Specialist administers the physician and mid-level enrollment applications process for Medicare and Medicaid.  The Provider Enrollment Specialist is responsible for preparing and submitting supporting documentation for the purpose of enrolling individual physicians, mid-levels and facilities with Medicare and Medicaid. This position is also responsible for follow up on the status of applications for physician, mid-levels, and facilities, and track the progress on all pending applications.

Essential Functions
  • Implements the physician enrollment process for physicians and mid-levels with Medicare and Medicaid.
  • Maintain the timelines on enrollment schedules, communicate with providers and other departments to update as needed, clarify carrier information requirements, and maintain a strict level of confidentiality for all matters pertaining to provider credentials.
  • Reviews new client packet information to determine any enrollment issues.
  • Coordinates credentialing data needed for enrollment, contracting, and other related purposes. Credentialing data includes but is not limited to the medical degree, Drug Enforcement Administration (DEA) number, state license number, Board certifications, CV, malpractice insurance and state insurance form.
  • Works closely with Physicians to obtain missing documentation for providers pertaining to provider enrollment.
  • Obtains required client signatures and follows up with the carriers on documentation submitted.
  • Maintains provider information and demographics for all providers.
  • Responds to internal and external inquiries on routine enrollment and contract matters.
  • Monitors and advises clients on enrollment revalidations.

Job Requirements

  • High School Diploma or GED required
  • Bachelor’ s Degree preferred

Work Experience:
  • Minimum of 2 years’ experience in a larger or similar-sized company required
  • Knowledge of Medicare and Medicaid provider enrollment process
  • Proficiency in Microsoft Office, particularly Word and Excel
  • Professional written and verbal communication and interpersonal skills.

Additional Knowledge, Skills and Abilities Required:
  • Proficiency in Microsoft Office, particularly Word and Excel
  • Professional written and verbal communication and interpersonal skills.
  • Ability to participate and facilitate group meetings
  • Ability to effectively communicate with team members, supervisors, JV partners, and insurance contacts
  • Ability to maintain complete confidentiality in handling sensitive enrollment issues.

Amber Meredith

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