Provider Enrollment Specialist

2 weeks ago


Nashville, Tennessee, United States CGS Administrators Full time
Position Overview:

The Provider Enrollment Specialist plays a crucial role in managing the provider enrollment process. This position is responsible for evaluating, investigating, and processing provider enrollment applications to ensure compliance with established standards and guidelines.


Key Responsibilities:
  • Assess the acceptability of provider enrollment applications, including initial full applications, reenrollment, reactivation, and changes in information.
  • Conduct thorough reviews and validations of provider data to ensure accuracy and authenticity.
  • Utilize various databases and organizations to verify provider information.
  • Set up and test Electronic Funds Transfer (EFT) accounts as necessary.
  • Input, update, and maintain provider data within the appropriate enrollment databases.
  • Deliver exceptional service and communicate effectively with both internal and external stakeholders in response to inquiries.
  • Gather information from various sources to resolve discrepancies and issues.
  • Provide enrollment applications and general information regarding the enrollment process to interested parties.
  • Contribute to special projects related to provider files and assist with process improvements.
  • Support Technical Support staff in testing system changes relevant to provider files.
  • Participate in provider education and training initiatives.

Work Environment:

This role is typically situated in an office setting.


Qualifications:

To be considered for this position, candidates should possess:

  • A Bachelor’s degree or four years of relevant work experience, including at least six months in an office environment.
  • Proficiency in word processing, spreadsheet, and database software.
  • Strong judgment and effective organizational skills.
  • Excellent verbal and written communication abilities.
  • Proficiency in spelling, punctuation, and grammar.
  • Basic business math skills and analytical thinking capabilities.
  • Ability to manage confidential information with discretion.
  • Familiarity with Microsoft Office applications.

Preferred Qualifications:

Experience with Medicare Part A/B is highly desirable.


Benefits:

CGS Administrators offers a comprehensive benefits package, including:

  • 401(k) retirement savings plan with company match.
  • Subsidized health plans and complimentary vision coverage.
  • Life insurance and paid annual leave.
  • Paid holidays and access to on-site cafeterias and fitness centers.
  • Wellness programs and tuition assistance.
  • Service recognition initiatives.

Equal Opportunity Statement:

CGS Administrators is committed to a policy of nondiscrimination in employment, promoting opportunities for individuals regardless of various protected statuses. We maintain affirmative action programs to support employment opportunities for minorities, females, disabled individuals, and veterans.



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