Provider Enrollment Specialist

2 weeks ago


Philadelphia, United States Global Force Full time
Provider Enrollment Specialist

Location : Philadelphia PA
19113

Contract: 3 months with possibility of extension

Under the direct supervision of the Provider Enrollment Supervisor, the Provider Enrollment Specialist is responsible for maintaining both participating and non-participating provider records in the provider database, mapping claims in the invalid provider queue, resolving provider related issues for claims suspended to Provider Enrollment. Executes the panel transfer process. Completes projects as assigned by Supervisor. Interacts with internal/external clients on provider maintenance activities.
• Communicates notification of changes to appropriate providers, members and other departments within the contracted time frame.
• Coordinates the provider mailing for all claims in the invalid provider queue that could not be processed due to missing or invalid information.
• Researches and resolves returned checks and provider mail.
• ssists provider and internal customer by responding to and resolving all request and inquiries related to the Panel Transfers, Panel Releases, & Special Needs PCP assignments process.
• Completes department reports and logs as assigned.
• Ensures that work is completed according to service level agreements.
• ttends required training on an annual basis.
Skills:
Knowledge of different types of providers, claims process exp preferred.
Customer service exp required.
Software systems including Windows 2000, MS Office, IMAX (external Claims editing),
Facets preferred.
Knowledge of Word, Excel, and ACCESS is a plus.
1-3 Years of Healthcare Experience
Minimum 4 years exp in claims and/or call center

Education: Associates Degree

  • Philadelphia, United States Global Force USA Full time

    Provider Enrollment Specialist Location : Philadelphia PA 19113 Contract: 3 months with possibility of extension Under the direct supervision of the Provider Enrollment Supervisor, the Provider Enrollment Specialist is responsible for maintaining both participating and non-participating provider records in the provider database, mapping...


  • Philadelphia, United States Jefferson Health Full time

    Job Summary: Responsible for the credentialing and enrollment of Jefferson Medical Group (JMG) physicians with contracted commercial and government payers. Works with assigned department staff to ensuring required documentaiton is obtained and complete for a smooth enrollment process. Responsibilities: Prepare initial and recredentialing plan applications...


  • Philadelphia, United States Jefferson Health Full time

    Job Summary: Responsible for the credentialing and enrollment of Jefferson Medical Group (JMG) physicians with contracted commercial and government payers. Works with assigned department staff to ensuring required documentaiton is obtained and complete for a smooth enrollment process. Responsibilities: Prepare initial and recredentialing plan applications...


  • Philadelphia, United States ACQ Inc. Full time

    Due to increased demand, we are expanding throughout the Philadelphia and South Jersey area. We proudly work alongside some of the most recognized brands in the country. Our job is to assist in the acquisition and enrollment of new customers. We pride ourselves on the work that we do for our clients and community, and our team finds much joy in being able to...


  • Philadelphia, United States AbsoluteCare Full time

    Description: Absolute Care offers concierge health services using a risk-bearing, PCP-driven care model. We treat the most clinically complex and vulnerable members of the communities we serve, many of whom suffer from behavioral health, substance use, and SDoH challenges. We use population health management tools to employ a holistic approach to caring...


  • Philadelphia, United States Trinity Health Full time

    Employment Type: Full timeShift: Day Shift Description: Enrollment Specialist Shift: Typical work schedule is Monday to Friday, 8 am to 5 pm with occasional evening or weekend hours required. Status: Full time Location: Mercy LIFE West Philadelphia Incentives: $5,000 Sign on Bonus AND 1st Day Benefits We are seeking a compassionate and sales minded...


  • Philadelphia, United States Trinity Health Full time

    Employment Type: Full time Shift: Day Shift Description: Enrollment Specialist Shift: Typical work schedule is Monday to Friday, 8 am to 5 pm with occasional evening or weekend hours required. Status: Full time Location: Mercy LIFE West Philadelphia Incentives: $5,000 Sign on Bonus AND 1st Day Benefits We are seeking a compassionate and sales...


  • Philadelphia, United States Community College of Philadelphia Full time

    Under the direction of the Manager, Enrollment Management Support, the Enrollment Support Specialist reviews educational credentials including postsecondary transcripts and determines appropriate placement for English and math; reviews educational credentials to determine proper course prerequisites and co-requisites for registration and transfer. Occasional...

  • Provider Specialist

    2 weeks ago


    Philadelphia, United States Knewin Full time

    PHMC is proud to be a leader in public health. PHMC requires all employees to be fully vaccinated for COVID-19 before the first day of employment. We will offer the vaccination at no cost via our Health Centers.*Job Overview:The Provider Specialist performs core functions of the Provider Services Team at the Early Learning Resource Center (ELRC). This...

  • Provider Specialist

    4 weeks ago


    Philadelphia, United States PHMC Full time

    PHMC is proud to be a leader in public health. PHMC requires all employees to be fully vaccinated for COVID-19 before the first day of employment. We will offer the vaccination at no cost via our Health Centers. JOB OVERVIEW: The Provider Specialist performs core functions of the Provider Services Team at the Early Learning Resource Center (ELRC). This...

  • Provider Specialist

    2 weeks ago


    Philadelphia, United States PHMC Full time

    PHMC is proud to be a leader in public health. PHMC requires all employees to be fully vaccinated for COVID-19 before the first day of employment. We will offer the vaccination at no cost via our Health Centers. JOB OVERVIEW: The Provider Specialist performs core functions of the Provider Services Team at the Early Learning Resource Center (ELRC). This...

  • Enrollment Associate

    3 weeks ago


    Philadelphia, United States Vitable health Full time

    Vitable Overview At Vitable Health, our team of engineers, clinicians, and operators are building a delightful and affordable primary care benefit designed specifically for the 80 million Americans who are uninsured or under-insured. We built Vitable because healthcare is complex and expensive, but everyone needs it. Our vertically integrated primary care...

  • Enrollment Associate

    4 hours ago


    Philadelphia, United States Vitable health Full time

    Vitable Overview At Vitable Health, our team of engineers, clinicians, and operators are building a delightful and affordable primary care benefit designed specifically for the 80 million Americans who are uninsured or under-insured. We built Vitable because healthcare is complex and expensive, but everyone needs it. Our vertically integrated primary care...

  • Enrollment Associate

    4 weeks ago


    Philadelphia, United States Vitable Health Full time

    Job DescriptionJob DescriptionVitable OverviewAt Vitable Health, our team of engineers, clinicians, and operators are building a delightful and affordable primary care benefit designed specifically for the 80 million Americans who are uninsured or under-insured.We built Vitable because healthcare is complex and expensive, but everyone needs it. Our...

  • Enrollment Associate

    18 hours ago


    Philadelphia, United States Vitable Health Full time

    Job DescriptionJob DescriptionVitable OverviewAt Vitable Health, our team of engineers, clinicians, and operators are building a delightful and affordable primary care benefit designed specifically for the 80 million Americans who are uninsured or under-insured.We built Vitable because healthcare is complex and expensive, but everyone needs it. Our...


  • Philadelphia, United States Community College of Philadelphia Full time

    Under the direction of the Manager, Enrollment Management Support, the Enrollment Support Specialist reviews educational credentials including postsecondary transcripts and determines appropriate placement for English and math; reviews educational credentials to determine proper course prerequisites and co-requisites for registration and transfer. Occasional...


  • Philadelphia, United States Corcentric Full time

    Job DescriptionJob DescriptionAs a Manager, Enrollments with our Order-to-Cash (O2C) team at Corcentric, you will join a fun, collaborative team within an ambitious, entrepreneurial global organization. You will drive the effectiveness and efficiency of our Enrollment & Enablement team, by providing day-to-day management and leadership. You will collaborate...


  • Philadelphia, United States Zolon Tech Solutions, Inc. Full time

    Title : Providers Contract Specialist Location : Philadelphia, PA Duration : 04 Months Job Description: Remote The Contract Specialist ensures contract data and documents are represented correctly in all plan operating systems, functions as a pro-active contract admin...


  • philadelphia, United States Zolon Tech Solutions, Inc. Full time

    Title : Providers Contract SpecialistLocation : Philadelphia, PADuration : 04 MonthsJob Description:RemoteThe Contract Specialist ensures contract data and documents are represented correctly in all plan operating systems, functions as a pro-active contract admin...


  • Philadelphia, United States ESPERANZA CYBER CHARTER SCHOOL Full time

    JOB DESCRIPTION: Esperanza Cyber Charter School (ECCS) is located in North Philadelphia and currently seeking mission-driven Enrollment & Attendance Assistant applicants that align with ECCS's mission and enthusiasm for equity. The Enrollment Assistant with clerical duties works full-time in person in the office, under the guidance and supervision of the...