Provider Enrollment Specialist

4 days ago

Concord, New Hampshire, United States Conduent Full time
Job Title: Provider Enrollment Specialist

Conduent is seeking a highly skilled and detail-oriented Provider Enrollment Specialist to join our team. As a Provider Enrollment Specialist, you will be responsible for ensuring the accurate and timely enrollment of healthcare providers into our system.

Key Responsibilities:

  • Enter and maintain provider applications, revalidations, and updates into the system.
  • Verify prospective and current providers' license, NPI, and other required enrollment documentation.
  • Verify accurate banking and billing information.
  • Perform ongoing research to correct data so that it does not create duplicate providers, locations, and participation statuses.
  • Maintain provider information by reviewing, entering, and following up on missing information.
  • Track contract applications status.
  • Ensure all files have a welcome, denial, or term letter as appropriate.
  • Meet required turnaround times and accuracy rates.
  • Keep up-to-date provider enrollment process and records, and track provider participation levels.
  • Outreach providers as a result of mail being returned undelivered to XYZ COMPANY.
  • Update the system and the credentialing database to reflect approvals, denials, and/or terminations.
  • Facilitate provider-related research based on suspended claims, Call Center escalations, and other feedback opportunities.
  • Assist call center agents, all internal departments, providers, and potential providers with resolving Provider Enrollment issues and inquiries.
  • Meet quality controls and production standards of the Provider Relations Department.
  • Assist with other duties as assigned.
  • Communicate with the Systems Team on identified Tech Errors in MMIS.

Requirements:

  • High school diploma or equivalent; Associates degree preferred.
  • 12 years of experience in a business environment.
  • System application aptitude to communicate and work with the Systems Team on MMIS technical errors during enrollment and provider data base management.
  • Previous experience working with files or the collection and coordination of data (preferred).
  • Proficient in the use of Excel.
  • Experience with general computer software (Word, Outlook required).
  • Ability to learn new software programs quickly.
  • Good basic math skills.
  • Excellent customer service skills.
  • Excellent verbal and written communication skills.
  • Professional and effective interaction skills with co-workers, clients, and providers.
  • Proven ability to work well individually and as a team member.
  • Ability to prioritize and organize multiple tasks.
  • Ability to remain organized with multiple interruptions.
  • Ability to make independent decisions.
  • Strong attention to detail.
  • Strong business acumen.
  • Ability to adapt to constantly changing environment.

Pay and Benefits:

The estimated pay for this role is $17.00 per hour. Conduent provides a variety of benefits to employees, including health insurance coverage, voluntary dental and vision programs, life and disability insurance, a retirement savings plan, paid holidays, and paid time off (PTO) or vacation and/or sick time.

Equal Opportunity Employer:

Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law.

Accommodation Request:

People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by clicking on the following link, completing the accommodation request form, and submitting the request by using the "Submit" button at the bottom of the form.

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