What are the responsibilities and job description for the Provider Enrollment Specialist, Applications, Onsite Phoenix Office position at Centauri Health Solutions?
Role Overview:
Provider Enrollment Specialist is a vital team member with Centauri’s Out of State Medicaid billing agency that works with facilities across the US to process their Out of State Medicaid claims with a focus on hospital billing, hospital and physician enrollment, and eligibility verifications. All team members are assigned tasks and are responsible for ensuring tasks are completed by the assigned follow up date. The position focuses on completing Out of State Medicaid hospital and physician enrollment applications.
This position will be located onsite at our Phoenix office: 2010 W. Whispering Wind Dr., Suite 101, Phoenix, AZ 85085.
Role Responsibilities:
Complete Training Plan
Employees must complete a training plan to master role responsibilities
Accounts are audited until training plan is completed in phases
Utilize internal user procedures
Knowledge of Out of State Medicaid payer guidelines
Management of assigned task listing
Meet daily productivity goals set by Management
Review all assigned tasks and complete by the set follow up date
Review accounts in a timely manner consistent with identified procedures
Prioritize workload based on follow up date, dollar amount, and/or filing limits
Document findings and status within the system
Identify Payor trends and submit the necessary system updates
Upload supporting documentation to the system
Work together within assigned groups to determine next steps
Utilize multiple systems to prepare enrollment applications and gather the necessary credentials for enrollment
Enrollment Applications
Prepare complex hospital and physician enrollment applications using various provider application formats, including paper forms and/or web portal submission
Prepare formal client requests for signatures and credentials according to client specifications
Utilize all resources available to obtain credentials and/or information to prepare enrollment forms and updates
Verify instructions for new enrollments and updates with Out of State Medicaid payers
Responsible for reviewing all client responses to enrollment request to ensure all requested information was received
Save new credentials/information when received and update client database. Including but not limited to hospital license, physician license, CLIA, DEA, liability insurance, board certification, proof of instate and/or Medicare enrollment, etc.
Research and understand various provider enrollment application formats, discover new information requested and make decisions to complete the tasks required
Role Requirements:
Minimum two years of medical administrative experience; Medicare and/or Medicaid knowledge. Preferred but not required:
Previous experience with all aspects of credentialing process; NPPES, PECOS
Knowledge of healthcare provider credentialing and licensure requirements
Professional and effective decision making, critical thinking, and communication skills with co-workers, clients, and payers; written and oral
1 year including Microsoft Office knowledge
Drafting letters/formal email requests, preparing documents, and utilizing PDF viewer/application to complete applications according to payer guidelines
Detail oriented and outstanding organizational skills with the ability to learn new programs and website interface
Ability to navigate multiple platforms daily
Proven ability to work independently and as a team member
Ability to prioritize, organize multiple tasks and remain organized with multiple interruptions
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Salary : $18 - $25