Provider Enrollment Specialist

2 weeks ago


Concord, United States Eventus WholeHealth Full time
Position Summary:
We're seeking a talentedProvider Enrollment Specialist to manage initial and ongoing credentialing needs for providers inConcord, NC. In this role, the Credentialing Assistant will communicate effectively with patients, facilities, care team advocates, care team coordinators and providers to ensure the patients' needs are being met in accordance with Eventus WholeHealth standards.

Duties/Responsibilities:

  • Receives information regarding new practitioners from clinics, onboarding, Medical Staff Office, and billing offices, which includes all mail, email and faxes received from Payers
  • Initiates the onboarding process of a new practitioner
  • Enters practitioner information into enrollment databases such as PECOS and/or various enrollment portals and ensures that the information in the databases is current and accurate.
  • Regularly reviews and edits provider CAQH records and verifies that all pertinent elements are captured in the databases and that it matches what is captured in the Credentialing database.
  • Tracks all steps taken in the enrollment process and logs the actions in the Credentialing database.
  • Communicates with various payers, clinics, billing offices, practitioners, and leadership regarding the status of enrollments on an ongoing basis as the primary contact for all enrollment issues.
  • Enters payer Provider Identification Numbers (PINs) and the effective date into the credentialing system once they are received and also relays this information to the billing department

EDUCATION AND/OR CERTIFICATIONS
High school diploma or general education degree (GED) required or equivalent combination of education and experiencerequired

SKILLS AND QUALIFICATIONS

  • 1 year of prior healthcare or medical related experience required
  • Credentialing database experience preferred
  • Knowledge of HIPAA privacy laws
  • Excellent PC skills required; strong excel skills preferred
  • Competent knowledge of Microsoft office; strong Excel skills required
  • Ability to workunder pressure of tight deadlines and complete task accurately
  • Ability to effectively handle multiple priorities
  • Strong level ofdetail and accuracy
  • Must possess an understanding and adherence of legal and regulatory agency rule and guidelines

WHAT WE OFFER

Our full-time positions offer provide:

  • A chance to be part of a growing and emerging culture
  • Paid time off benefits
  • Holidays and Floating Holidays
  • Health benefits (medical, dental, vision)
  • Short & Long-term disability options
  • Employer Contribution to 401k Retirement after 6 months

About Eventus WholeHealth:
Eventus WholeHealth was founded in 2014 to provide physician-led healthcare services for residents and patients of skilled nursing and assisted living facilities. With our highly trained team of physicians, psychiatrists, nurse practitioners, physician assistants, psychotherapists, podiatrists, optometrists, audiologists, and support staff, our comprehensive, evidence-based model provides collaborative interdisciplinary care with the seamless and vital integration of a wide range of specialties. Our differentiated approach not only empowers the facilities to reach their own goals and objectives but also ensures better patient outcomes. For more information, please visit www.eventuswholehealth.com.

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