Provider Enrollment Specialist
4 days ago
Overview:
At St. Lukes, we pride ourselves on fostering a workplace culture that values diversity, promotes collaboration, and prioritizes employee well-being. Our commitment to excellence in patient care extends to creating an environment where our team can thrive both personally and professionally. With opportunities for growth, competitive benefits, and a supportive community of colleagues, St. Lukes is truly a great place to work.
Overview:
The Provider Enrollment Specialist coordinates the provider payer enrollment process to ensure compliance as addressed in payer contracts and other regulatory standards. Looking for candidates with experience in Provider Enrollment, Credentialing, Insurance, Insurance Customer Service, Billing or Coding. This position is M-F and willing to hire remote IF candidate is currently located in IDAHO or OREGON.
What to Expect:
- Responsible for the ensuring timely enrollment of new providers with 3rd party and government payers; and maintenance of existing active physicians and advanced practice providers.
- Validates up-to-date plan enrollment forms, completes applications, submits and follows up until enrollment is complete. Verifies accuracy and coordinates entry of new and revised provider information into database.
- Knowledgeable with Group Entity health plan enrollments, state regulations and appeal processes.
- Prepares/reviews group applications based on information provided during acquisitions, Tax ID mergers, etc.
- Monitors all assigned delegated agreement health plan enrollments reports utilized to provide oversight to ensure enrollments currently assigned are being processed timely.
- Validates status of on boarding providers enrollments to ensure target start date is met. Escalates to management when necessary, in order to meet desired target start date.
- Work closely with credentialing team to coordinate enrollment efforts and meet appropriate deadlines as a team.
- Responsible for the on-going maintenance of existing providers including but not limited the submission of maintenance forms to update personal and practice demographic data for providers, billing updates, etc.
Qualifications:
- Education: Associate degree.
- Experience: 3 years' experience.
At St. Lukes, caring for people in the communities we serve is our mission and this includes our own SLHS team. We offer a robust benefits package to support our teams both professionally and personally. In addition to a competitive salary and retirement plans, we ensure our team feels supported in their benefits beyond the typical medical, dental, and vision offerings. We care about you and have fantastic financial and physical wellness options, such as: on-site massages, on-site counseling via our Employee Assistance Program, access to the Virgin Pulse Wellness tool, as well as other formal training and career development offerings to ensure you are meeting your career goals.
St. Lukes is an equal opportunity employer and does not discriminate against any person on the basis of race, religion, color, gender, gender identity, sexual orientation, age, national origin, disability, veteran status, or any other status or condition protected by law.
*Please note: this posting is not reflective of all job duties and responsibilities and is intended to provide an overview to job seekers.
Whats in it for you:At St. Lukes, caring for people in the communities we serve is our mission and this includes our own SLHS team. We offer a robust benefits package to support our teams both professionally and personally. In addition to a competitive salary and retirement plans, we ensure our team feels supported in their benefits beyond the typical medical, dental, and vision offerings. We care about you and have fantastic financial and physical wellness options, such as: on-site massages, on-site counseling via our Employee Assistance Program, access to the Virgin Pulse Wellness tool, as well as other formal training and career development offerings to ensure you are meeting your career goals.
St. Lukes is an equal opportunity employer and does not discriminate against any person on the basis of race, religion, color, gender, gender identity, sexual orientation, age, national origin, disability, veteran status, or any other status or condition protected by law.
*Please note: this posting is not reflective of all job duties and responsibilities and is intended to provide an overview to job seekers.
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