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Healthcare Provider Enrollment Specialist II

2 months ago

Harrisburg, Pennsylvania, United States Elevance Health Full time
About the Role

We are seeking a skilled Healthcare Provider Enrollment Specialist II to join our team at Elevance Health. As a key member of our organization, you will play a critical role in ensuring the accurate and timely processing of Part B provider enrollment applications.

Key Responsibilities
  • Maintain critical provider information on all claims and provider databases.
  • Synchronize data among multiple claims systems and apply business rules as they apply to each database.
  • Validate the data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management, and credentialing.
Requirements
  • Requires a H.S. diploma; 3-5 years related experience in claims processing, provider relations/customer service, or credentialing; or any combination of education and experience, which would provide an equivalent background.
  • This position is part of our NGS (National Government Services) division which, per CMS TDL 190275, requires foreign national applicants meet the residency requirement of living in the United States at least three of the past five years.
Preferred Skills
  • Medicare Provider Enrollment Part B experience is preferred.
  • Experience using the PECOS database is preferred.
  • Strong typing/data entry skills preferred.
  • Knowledge of Microsoft Office applications specifically Microsoft Excel and Word are strongly preferred.
About Elevance Health

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs, and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.