Provider Enrollment Specialist

Title: Provider Enrollment Specialist

Integrated Physicians Management Services (IPMS) , a premier Medical Practice Management Services Organization located in East Hartford CT, has an opening for a certified Provider Enrollment Specialist in our Credentialing Department. If you enjoy working in a supportive and collaborative environment and are ready to excel in a dynamic atmosphere where your contributions are valued, apply now! Our mission at IPMS is to deliver quality services and maximize our client's cash flow through specialized billing. To successfully do so, we are searching for qualified, dedicated, candidates who are open to being challenged with the full support of a close-knit team.

Why work for IPMS?

We are Celebrating Over 25 Years in Business!

IPMS was voted as one of the BEST places to work in 2023!

HYBRID SCHEDULES - Once you successfully complete your orientation with IPMS, you will discuss your schedule with your manager. When able to work independently, IPMS employees may work a hybrid in-office and remote schedule.

FLEXIBLE WORK SCHEDULES - Our schedule allows you a flexible start time with a two-hour window to start and end your day.

WORK FAMILY GATHERINGS - At IPMS, we gather to celebrate our success monthly and strive to continually foster a community atmosphere.

COMPETITIVE PAY & FANTASTIC BENEFITS

At IPMS we offer generous time off accruals to enhance your opportunity for work life balance. We offer immediate eligibility in our retirement program and provide many employer sponsored benefits including fully paid Life and Disability insurance. At IPMS we have an Employee Assistance program to help with everyday struggles as balancing our personal and work lives becomes more challenging. We also offer a variety of voluntary benefits, including legal, identity theft protection, and pet insurance!

OPPORTUNITIES FOR LEARNING - IPMS provides learning opportunities through special projects for those who want to expand their knowledge in the field.

POSITION SUMMARY

The primary purpose of the position is to assure that all clinical providers are practicing as credentialed participants with each payer. Administers the credentialing for multiple client practices of various specialties in order to achieve maximum reimbursement for medical services. Builds and maintains positive working relationships with IPMS employees, clients and all outside contacts. Assures ongoing communications with IPMS billing and Management teams on all credentialing matters necessary for the proper reimbursement of client services. Performs additional duties and special projects as needed.

ESSENTIAL RESPONSIBILITIES:

• Establishes excellent working rapport with carrier representatives, ICP members, Physicians, Practice Administrators and all IPMS employees in order to provide ongoing communications during the credentialing process. Maintains current contacts and shares with all department members for effective follow up on all credentialing matters.
• Maintains records for providers utilizing OneApp software. Properly utilizes software features to flag items for follow up assuring that proper notification is given to the client prior to action being taken.
• Requests credentialing documents and licensure from clients in order to complete applications for signatures. Follows-up frequently when information is not returned in a timely fashion.
• Completes credentialing applications for each client with all payers the group participates with as well as each PHO of the client working at more than one location/hospital. Prepares privilege appointment and re-appointment applications for selected clients. Maintains/completes re-credentialing applications for established clients with all payers to assure smooth and uninterrupted reimbursement.
• Processes applications and follows-up with payers frequently to assure acceptance in the timeliest fashion. Responds to requests for additional information.
• Establishes and maintains relations with medical liability carriers, completing applications as required by client(s).
• Maintains client files and data sources and assures documentation is up to date, i.e., licensure and other credentialing-related documents.
• Updates and maintains weekly status reports for management staff and clients as requested.
• Obtains provider ID#’s from payors in order to be able to bill for provider’s services. Provides updates database of information and circulates to appropriate IPMS employees and clients.

Education: High school diploma

Experience: minimum of five years’ experience in a Credentialing role managing multiple providers and understanding of multiple specialties or equivalent education and experience in a similar role within a hospital, large private practice or Medical Management Services Organization. Knowledge of managed care, commercial and federal agencies or basic understanding of general medical terminology as well as CPT and ICD9/10 codes is required. Must have proficient organizational skills and the ability to remain calm under pressure. Possesses effective communication skills in order to provide outstanding customer support to IPMS employees and clients including doctor’s offices, hospital administration, physicians and nurses. Proficiency with Windows-based software and Internet, along with electronic filing systems required. This position is in a general office environment

Job Type: Full-time

Pay: $30.00 - $35.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• AD&D insurance
• Dental insurance
• Disability insurance
• Employee assistance program
• Flexible schedule
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Parental leave
• Vision insurance

Schedule:

• Monday to Friday

Experience:

• payer credentialing: 5 years (Required)

Ability to Relocate:

• East Hartford, CT 06108: Relocate before starting work (Required)

Work Location: Hybrid remote in East Hartford, CT 06108

Salary : $30 - $35