Provider Enrollment Specialist

2 weeks ago

Allentown, United States St. Luke's University Health Network Full time


St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care.

The Provider Enrollment Specialist ensures that initial and re-credentialing applications for St. Luke’s University Health Network (SLUHN) employed providers’ are submitted to identified third party and government health insurance carriers. Responsibilities also include maintaining membership and renewal information for professional and DEA licenses, board certification and professional organization memberships.

JOB DUTIES AND RESPONSIBILITIES:

  • Prepares provider enrollment applications and/or written link letters to be sent to payers

  • Ensures all providers and groups are re-validated with payers on a timely basis by completing re-credentialing applications with current provider information and signatures.

  • Makes and receives phone calls from providers and practice managers to help resolve payer issues and verify participating status.

  • Updates & maintains database to show enrollment tracking, effective dates, provider numbers and correct provider demographics.

  • Scans and files all paperwork and documents to a shared folder for tracking purposes and proof of submission to payers.

  • Applies for New Jersey licensure for identified providers.

  • Creates and submits new group enrollment applications for newly opened or moving practices. Fields and responds timely to inquiries from SLUHN departments to help resolve enrollment related issues.

  • Ensures SLUHN billing department has resolution on enrollment issues that assist with claim processing.

  • Identifies and communicates current or potential enrollment issues that could result in loss of revenue and/or patient dissatisfaction.

  • Participates in team meetings and conference calls with payers.

  • Completes online applications for Doing Business As (DBA) for new or renamed groups.

  • Creates check requests for out-of-state enrollment fees.

PHYSICAL AND SENSORY REQUIREMENTS:

Requires sitting for up to eight hours per day, including extensive use of computer terminal and telephone.  Requires hearing as it relates to normal conversation and answering questions in large groups. Requires seeing as it relates to general near and far vision.

EDUCATION:

High School Education

TRAINING AND EXPERIENCE:

Experience with personal computers and the Microsoft Office suite of products is required. Strong customer service skills. Excellent verbal and written communication skills. Detail and service oriented.

Please complete your application using your full legal name and current home address.  Be sure to include employment history for the past seven (7) years, including your present employer.  Additionally, you are encouraged to upload a current resume, including all work history, education, and/or certifications and licenses, if applicable.  It is highly recommended that you create a profile at the conclusion of submitting your first application.  Thank you for your interest in St. Luke's



St. Luke's University Health Network is an Equal Opportunity Employer.

  • Provider Enrollment Specialist

    1 week ago

    Allentown, United States St. Luke's University Health Network Full time

    St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other...

  • Provider Enrollment Specialist

    1 week ago

    Allentown, PA, United States St. Luke's University Health Network Full time

    St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other...

  • Provider Enrollment Specialist

    7 days ago

    Allentown, PA, United States St. Luke's University Health Network Full time

    St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other...

  • Applications Specialist

    3 weeks ago

    Allentown, United States St. Luke's University Health Network Full time

    St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other...

  • Direct Market Manager

    4 months ago

    Allentown, United States ThinkTank Full time

    ThinkTank Telecom, LLC is actively seeking a motivated and entrepreneurial Direct Market Manager to lead our expansion efforts in Allentown, PA. As the cornerstone of our mission to enhance connectivity, your role will focus on enrolling new customers into Lifeline and ACP services, managing inventory, and driving significant sales performance in your...

  • Direct Market Manager

    6 months ago

    Allentown, United States ThinkTank Full time

    ThinkTank Telecom, LLC is actively seeking a motivated and entrepreneurial Direct Market Manager to lead our expansion efforts in Allentown, PA. As the cornerstone of our mission to enhance connectivity, your role will focus on enrolling new customers into Lifeline and ACP services, managing inventory, and driving significant sales performance in your...

  • Direct Market Manager

    4 weeks ago

    Allentown, United States ThinkTank Full time

    ThinkTank Telecom, LLC is actively seeking a motivated and entrepreneurial Direct Market Manager to lead our expansion efforts in Allentown, PA. As the cornerstone of our mission to enhance connectivity, your role will focus on enrolling new customers into Lifeline and ACP services, managing inventory, and driving significant sales performance in your...

  • Claims Specialist

    3 weeks ago

    Allentown, United States Indotronix Avani Group Full time

    Title: Property Damage Claims SpecialistLocation: Allentown, PADuration: 6 + monthsPay: $28/hrWe are seeking a damage claims specialist to handle customer property damage claims that may occur allegedly due to the operations or providing of electric service.Responsibility includes the accurate and timely processing of customers claims, while conforming to...

  • Food Preparation Specialist

    7 hours ago

    Allentown, Pennsylvania, United States Miller's Ale House Full time

    Job DescriptionWe are seeking a dedicated Food Preparation Specialist to join our team at Miller's Ale House. In this role, you will be responsible for ensuring a supply of clean and ready dish supplies for Cooks.Key Responsibilities:Work directly with both BOH (Back of House) and FOH (Front of House) team members to ensure all needs are fulfilled in a...

  • Travel Imaging Specialist

    1 day ago

    Allentown, Pennsylvania, United States TotalMed Allied Full time

    TotalMed Allied is seeking a skilled Travel Imaging Specialist for a 12-week travel assignment in Pennsylvania.Job SummarySpecialty: Interventional Radiology TechnologistDiscipline: Allied Health ProfessionalWe are looking for an experienced Interventional Radiology Technologist to work in Allentown, Pennsylvania. The ideal candidate will have excellent...

  • Financial Operations Specialist

    1 month ago

    Allentown, Pennsylvania, United States PMA Companies Full time

    Financial Operations SpecialistPMA Companies is seeking a highly skilled Financial Operations Specialist to join our team. As a key member of our finance department, you will be responsible for preparing various general ledger journal entries, reconciliations, and cash collection schedules. Your attention to detail and analytical skills will be essential in...

  • Travel Nurse RN Specialist

    3 weeks ago

    Allentown, Pennsylvania, United States Planet Healthcare Full time

    Planet Healthcare is seeking a highly skilled Travel Nurse RN Specialist to provide expert care in a Progressive Care Unit setting.Job DetailsSpecialty: Progressive Care UnitDiscipline: RNEmployment Type: TravelAs a key member of our team, the Travel Nurse RN Specialist will work closely with our dedicated healthcare professionals to deliver top-notch...

  • Quality Assurance Specialist

    1 month ago

    Allentown, Pennsylvania, United States B. Braun Medical Inc Full time

    About the Role:B. Braun Medical Inc. is seeking a Quality Assurance Specialist to join our team. As a Quality Assurance Specialist, you will be responsible for reviewing and establishing quality standards for products and processes, identifying and mitigating quality risks, and conducting root cause analysis for defects and...

  • Customer Process Specialist>

    6 months ago

    Allentown, United States Airgas Full time

    Airgas, Inc. - JobID: R10040676 [Customer Service Representative] As a Customer Process Specialist at Airgas, you'll: Assist customers via telephone, email, fax, or in person facilitating all phases of order-fulfillment for industrial, medical and specialty gases; Answer and respond to incoming telephone inquiries from customers; Provide research and resolve...

  • Senior Email Marketing Specialist

    4 weeks ago

    Allentown, Pennsylvania, United States Mondo Full time

    Job Title: Senior Email Marketing SpecialistDescription: We are seeking a highly skilled Senior Email Marketing Specialist to join our team at Mondo. The ideal candidate will have a strong background in email marketing, with experience in strategizing and executing email campaigns that drive results.Responsibilities:* Develop and implement email marketing...

  • Dental Hygienist

    4 weeks ago

    Allentown, Pennsylvania, United States 360care Full time

    Job Title: Dental Hygienist - Independent Practice SpecialistJob Description:We are seeking a skilled Dental Hygienist to join our team at 360care. As an independent practice specialist, you will have the opportunity to focus on providing high-quality patient care while we handle the administrative tasks.Responsibilities:Provide dental hygiene services to...

  • Logistics Specialist

    2 weeks ago

    Allentown, United States Kelly Full time

    Position Title: Logistics Specialist Shift: 1st Shift – 7:00 AM to 4:30 PM Pay Rate: $27 - $30 Hourly (Depending on Experience) Location: Allentown, PA 18109 Benefits: Medical, Dental, Vision, 401K, Vacation, Sick Time, & Holiday Pay Kelly Services is excited to partner with Johnson & Johnson in the search for a highly organized and detail-oriented...

  • Customer Experience Specialist

    1 month ago

    Allentown, Pennsylvania, United States Norman's Gift Shops, Inc. Full time

    Job DescriptionNorman's Gift Shops, Inc. is seeking a qualified Part Time Sales Associate for our location in the East. We are in the business of helping people capture their emotions and share them with one another. Our customers entrust us to help them show how much they care, to commemorate their most special occasions, provide comfort through challenging...

  • Benefits Specialist

    1 week ago

    Allentown, United States St. Luke's University Health Network Full time

    St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other...

  • Utility Specialist

    6 days ago

    Allentown, Pennsylvania, United States Commonwealth of Pennsylvania Full time

    Job SummaryThe Department of Transportation is seeking a highly skilled Utility Relocation Specialist to join their team. In this role, you will be responsible for offering specialized technical knowledge and support for utility relocation initiatives.Description of WorkAs a Utility Relocation Specialist, you will create, assess, and propose utility...