What are the responsibilities and job description for the Provider Enrollment Specialist II or III position at Medical Provider Resources?
Work Location: in person only.
Medical Provider Resources (MPR) is an established firm that provides provider enrollment services to healthcare entities who wish to obtain health plan enrollment services for healthcare providers. Services vary on what activities are required. Our mission is focused on supporting health care providers, group practices, facilities, and networks by responding efficiently to the growing demands for credentialing requirements.
MINIMUM REQUIREMENTS
Competency
- Knowledge of payer enrollment processes and requirements, including PECOS and CAQH.
- Strong attention to detail, organizational skills, and the ability to manage multiple tasks in a fast-paced environment.
- Demonstrate accuracy, organizational and problem-solving skills.
- Excellent verbal and written communication skills.
- Ability to work independently.
- Maintains confidentiality.
Required Education and Experience (Provider Enrollment Specialist II)
- 3 years of Provider Enrollment Experience preferred.
- Must be working toward PE Certification.
- Experience with CAQH, PECOS and Availity.
- Proficient in Microsoft 365.
- Familiar with Internet.
- Excellent written and verbal communication skills.
- Experience with credentialing software.
Preferred Education and Experience (Provider Enrollment Specialist III)
- Relevant education and certification a plus.
- 5 years of experience preferred.
MAIN DUTIES
- Enroll providers in health plans.
- Coordinates credentialing data needed for enrollment, contracting, and other related purposes.
- Creation and Maintenance of CAQH Application.
- Ongoing monitoring and support of provider documentation including Kansas State or Other State Licensure, DEA, NPI, Certificate of Insurance and other documents as required by the regulatory agencies.
- Complete hospital applications, as requested by the client or the provider.
- Complete Third-Party Payer Applications.
- The ability to work with diverse internal and external customers.
- Terminating providers with current practice from the request of the client.
Wage amount will commensurate with experience.