Provider Enrollment Specialist

4 weeks ago


Caribou, Maine, United States Cary Medical Center Full time
Job Summary

Cary Medical Center is seeking a highly skilled Provider Enrollment Specialist to join our team. As a key member of our healthcare team, you will be responsible for overseeing the entire provider enrollment process, ensuring seamless interactions with payers, and maintaining accurate provider information.

Key Responsibilities
  1. Enroll new and established providers with various health plans, including Medicare, Mainecare, and Anthem.
  2. Prepare and submit credentialing applications, ensuring timely completion and follow-up with payers.
  3. Maintain accurate provider information, including demographics and licensure details.
  4. Collaborate with Medical Staff Services to obtain missing documentation and resolve issues related to provider participation.
  5. Monitor and plan for updates related to licensure expirations and renewals.
  6. Resolve issues related to provider participation and verify provider loads are completed correctly.
  7. Conduct training as needed in regard to payer enrollment and coordinate responses to inquiries regarding payer and enrollment information.
Requirements
  1. Knowledge of provider enrollment processes and requirements for commercial, state, and community insurance companies.
  2. Ability to interact with tact and diplomacy with individuals from various backgrounds and organizational levels.
  3. Effective communication skills, both written and verbal, and ability to work independently.
  4. Demonstrated PC skills, including proficiency in Microsoft Office products and ability to multi-task.
  5. NAMSS certification, preferred but not required.
About Cary Medical Center

Cary Medical Center is a leading healthcare provider dedicated to delivering exceptional patient care and services. We are committed to fostering a collaborative and supportive work environment that promotes professional growth and development.



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