Provider Enrollment Specialist

6 days ago


Urbana, Illinois, United States Carle Foundation Hospital Full time
Job Title: Provider Enrollment Specialist

We are seeking a highly organized and detail-oriented Provider Enrollment Specialist to join our team at Carle Foundation Hospital.

Job Summary:

The Provider Enrollment Specialist is responsible for ensuring timely completion of enrollment forms for individual practitioners and facilities, enabling them to meet billing and reporting requirements for commercial, state, and government agencies.

Key Responsibilities:
  • Assemble and complete Center for Medicare and Medicaid Applications via PECOS or paper application for all lines of business.
  • Monitor, document, and communicate application status to ensure claims can be released for billing.
  • Complete or assign CMS-related applications and change notifications to third-party consultants.
  • Monitor and update revalidations for individuals and entities.
  • Complete enrollment forms for federal and non-federal payors, including roster updates and Electronic Funds Transfer forms.
  • Apply for NPI for all lines of business and individual providers.
  • Ongoing education and online seminars to stay current with CMS and IDPH processes.
  • Submission and attestation for Meaningful Use programs.
  • Maintain proficiency in Medical Staff Office credentialing software and provider lists.
  • Update the Provider Enrollment Information and Procedure Manual as needed.
Requirements:
  • Associate's degree in a related field or 5 years of relevant experience.
  • 1 year of general administrative services experience.
  • Proficiency in PC and Microsoft Office Suite applications, including database management and internet research.
  • Excellent written and verbal communication skills.
  • Ability to develop process improvements and work with all levels of staff and third parties.
What We Offer:

Carle Foundation Hospital is an equal opportunity employer and does not discriminate against any employee or applicant based on protected class. We participate in E-Verify and require the COVID-19 vaccine for all new team members, with medical or religious exemptions permitted.



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