Provider Enrollment Specialist

21 hours ago


Grand Rapids, Michigan, United States Hope Network Full time
Job Overview

Hope Network is seeking a skilled Provider Enrollment Specialist to join our team. As a key member of our enrollment team, you will be responsible for ensuring timely and accurate enrollment of clinical and professional staff with all payers.

Key Responsibilities
  • Enroll and maintain provider information with payers, ensuring compliance with all relevant regulations and guidelines.
  • Process and maintain new and existing member enrollments and disenrollments, adhering to departmental procedures and payer requirements.
  • Provide exceptional customer service to internal and external stakeholders, addressing enrollment-related inquiries and concerns in a timely and professional manner.
  • Stay up-to-date on payer enrollment and eligibility rules, applying this knowledge to facilitate smooth enrollment processes.
  • Monitor and reconcile errors and rejections related to provider enrollment, ensuring timely resolution and revenue collection.
  • Collaborate with internal departments to develop and review processes, resolving issues in a timely and efficient manner.
Requirements
  • Bachelor's degree in a related field or 3-5 years of experience in credentialing and/or provider enrollment.
  • Knowledge of the healthcare industry and enrollment processes for commercial insurances, including federal and state guidelines.
  • Proficiency in PC skills, including MS Office products and project management tools.
  • Ability to multitask and navigate complex environments, with strong analytical and problem-solving skills.
  • Excellent communication and interpersonal skills, with a focus on delivering exceptional customer service.
What We Offer
  • Competitive hourly rate, with opportunities for growth and advancement.
  • A comprehensive benefits package, including medical, vision, and dental care.
  • A 403(b) retirement plan and educational reimbursement opportunities.
  • A supportive and diverse work environment, with a focus on career development and growth.


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