What are the responsibilities and job description for the Provider Enrollment Specialist position at Heart of the Rockies Regional Medical Center?
Position: Provider Enrollment Specialist
Company: Heart of the Rockies Regional Medical Center
Location: Salida, CO, USA
Contract Details: Full-time
Heart of the Rockies Regional Medical Center is seeking a highly organized and detail-oriented Provider Enrollment Specialist to join our team in Salida, CO. As a leading healthcare provider in the region, we are committed to providing exceptional care to our patients and community. The Provider Enrollment Specialist will play a crucial role in ensuring that our healthcare providers are properly enrolled and credentialed with insurance companies and government programs.
Key Responsibilities:
- Accurately completes initial/revalidation enrollments and reassignments with all government and commercial insurance payers.
- Coordinates with HRRMC Medical Staff office, providers, and outside organizations to obtain information needed for payer enrollments.
- Ensures current information is on file for all employed providers and all pertinent documentation is forwarded to appropriate third party payers.
- Maintains common data file shared by HRRMC Administration and Medical Staff office.
- Completes and coordinates correspondence to third party payers to expedite provider number assignments and/or revalidation/termination.
- Tracks expiring licenses, certificate of insurance (COI), etc. and proactively updates with payers.
- Maintains provider CAQH, PECOS, NPPES, and Medicaid Profiles.
- Audits Health Plan Directories and ensures accuracy.
- Manages the Provider Enrollment email and responds timely/accurately.1
- Proactively obtains updated information and provides rosters as needed to payers.
- Maintains strict confidentiality of all information.1
- Investigates and resolves any provider enrollment issues that may arise with payers and billing/authorization.
Qualifications:
- Minimum of 2 years previous experience in Provider Enrollment, Payment Posting, Billing, and/or Collections; or equivalent combination of education and experience.
- Preferred 1 year direct experience in Provider Enrollment.
We offer a competitive salary and benefits package, including medical, dental, and vision insurance, retirement plans, and paid time off. If you are a motivated and detail-oriented individual with a passion for healthcare, we encourage you to apply for this exciting opportunity to join our team at Heart of the Rockies Regional Medical Center.
