Dental Provider Enrollment Specialist
2 days ago
The Aspen Group (TAG) is a leading provider of retail healthcare business support services, serving 15,000 healthcare professionals and team members across 46 states. As a key member of our Payor Strategy Team, the Provider Enrollment Specialist plays a vital role in ensuring that Aspen providers are enrolled with assigned dental plans and remain active.
Key Responsibilities- Submit and process initial enrollment applications and re-enrollment applications to assigned plans.
- Proactively maintain files and complete re-enrollment to avoid any lapse in provider participation.
- Maintain organized and complete files of all relevant documentation and applications.
- Responsible for following up on outstanding enrollment information and/or paperwork from providers to ensure timely processing.
- Utilize knowledge and skill set to complete all enrollment documentation with a high degree of accuracy to avoid denials.
- Track and follow up on enrollment or re-enrollment applications with payers until provider enrollment or re-enrollment is completed.
- Responsible for provider file maintenance with the payers, including but not limited to provider name changes, required attestations, and any other payer required data.
- Establish and maintain professional working relationships with key contacts, both internal and external.
- Work closely with RCM and Operations to ensure reimbursement is accurate and quickly resolve any escalated items.
- Demonstrate exemplary customer service to our plan partners, providers, and other TAG employees.
- Meet targeted enrollment deadlines.
- Communicate risk to leadership as soon as identified.
- High School Diploma or equivalent required, College Degree preferred.
- 5 years of relevant dental or insurance plan experience.
- Excellent verbal and written communication skills.
- Excellent time management, prioritization, and organizational skills a must.
- Detail-oriented with a strong level of analytical and problem-solving skills.
- Proficient use of Microsoft Office Suite, particularly Excel.
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