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Provider Enrollment Specialist
2 months ago
About American Vision Partners
At American Vision Partners, we are a leading provider of eye care services, operating over 100 eye care centers across the United States. Our mission is to provide the highest quality patient care possible, while also pioneering research and technology in the field of ophthalmology.
Job Summary
We are seeking a highly skilled and detail-oriented Provider Enrollment Specialist to join our team. As a Provider Enrollment Specialist, you will be responsible for assisting with the administration of the provider enrollment process for assigned new and existing providers. This includes preparing and submitting enrollment applications, initiating and managing new enrollments, and maintaining accurate records of enrollment status.
Key Responsibilities
- Enrollment Application Preparation: Prepare and submit enrollment applications for practitioners and group practices, ensuring all necessary information is included.
- Enrollment Management: Initiate and manage new enrollments, ensuring timely completion and follow-up with payers as needed.
- Record Keeping: Maintain accurate and up-to-date records of enrollment status, using Smart Sheets to track progress and identify areas for improvement.
- Communication: Communicate effectively with providers, insurance representatives, and other stakeholders to ensure seamless enrollment processes.
- Compliance: Ensure compliance with NCQA, Medicare, and Medicaid standards, as well as department procedures and guidelines.
- Confidentiality: Maintain strict confidentiality and adhere to all HIPAA guidelines and regulations.
Requirements
- Education: High School Diploma or equivalent; Associate's Degree preferred or 2 years of office business experience in lieu of Associate Degree.
- Certification: Provider Enrollment Specialist Certificate (PESC) or Certified Provider Credentialing Specialist (CPCS) or similar certification in credentialing, health plan, or network management required.
- Experience: 2-3 years of experience in Provider Enrollment and Credentialing fields required.
- Skills: Strong organizational skills, attention to detail, excellent communication skills, and problem-solving abilities within a team environment.
Benefits
We offer a comprehensive benefits package, including medical and dental insurance, significant eye care discounts, child care assistance, pet insurance, continuing education funds, 401(k), paid holidays, PTO, and sick time. We are committed to providing a supportive and inclusive work environment that fosters growth and development.
