What are the responsibilities and job description for the Provider Enrollment Specialist position at MCR Health, Inc?
Why MCR Health?
A career at MCR Health offers exciting opportunities with one of the largest Healthcare companies in the areas we serve. Now, more than ever, we are looking for exceptional people to support our passion to provide "Exceptional Care to Everyone, Every Time", and to support our Mission to serve everyone. Whether you are providing direct patient care or in other areas of our company, you can find a home here. We invite you to be part of our Company where you can grow your career and serve with your heart.
In our time of Company growth, we are seeking a Provider Enrollment Specialist.
Work Location: Bradenton, Florida.
As part of this role, you will:
- Complete insurance enrollment applications following the organization standards, state & federal regulations, guidelines, procedures & laws required in credentialing process Responsible for initial credentialing with insurance companies
- Ensure that the credentialing and re-credentialing process is completed in its’ entirety promptly by individual providers, as well as by the organization
- Responsible for notifying the appropriate managers of any credentialing issues, status on outstanding applications, changes with contracted insurance companies, and new plans within the company’s services delivery area
- Handle telephone communications to answer credentialing and staff questions regarding provider participation, credentials, documentation, etc.
- Obtain signatures in the field as required to complete the credentialing process
- High School Graduate or GED equivalent
- Minimum of two (2) years of experience preferred
- Ability to prove graduation from an accredited school
- Microsoft Office Products – Word, Excel, Outlook, PowerPoint proficiency preferred.
- Must have (PECOS, CAQH, etc..) experience
- Must be able to organize data for easy retrieval
- Must have a working knowledge of Managed Care
- Must have a working knowledge of Medicaid, Medicare, and private insurance
- Must have experience and/or education in computer data entry
- Must demonstrate interpersonal skills in written and oral communication, problem-solving, and teamwork
- Must have excellent grammar skills
- Must be able to meet deadlines and complete assignments promptly
- Medical terminology knowledge helpful
