Physician Enablement Specialist

3 weeks ago


Houston, Texas, United States Privia Health Full time
Job Title: Physician Enablement Specialist

Join Privia Health, a technology-driven company that optimizes physician practices and improves patient experiences, as a Physician Enablement Specialist. This role is a hybrid position that requires working in the office on Tuesdays and Thursdays and working from home on Mondays, Wednesdays, and Fridays.

Job Summary

The Physician Enablement Specialist is responsible for all aspects of credentialing, re-credentialing, and privileging processes for launching providers in Privia's high-performance medical group. This includes ensuring timely resolution and completion of payor enrollment, following health plan requirements, and working with internal and external stakeholders to resolve complex provider enrollment issues.

Key Responsibilities
  • Ensure timely payor enrollment and resolution of claim denials related to provider enrollment
  • Follow health plan requirements and guidelines for provider certification and credentialing
  • Streamline processes and workflows for the on-boarding department using automation
  • Work with internal and external stakeholders to resolve complex provider enrollment issues
  • Support special projects requiring knowledge of delegated and non-delegated health plan requirements
  • Maintain up-to-date data for each provider in credentialing databases and online systems
  • Maintain confidentiality of provider information
  • Coordinate and prepare reports and track credentialing statistics
Requirements
  • At least 3 years' experience in managed care credentialing
  • At least 2 years' experience in hospital credentialing and enrollment
  • Experience with TX commercial and government payers required
  • Provider enrollment experience required
  • MS Excel proficiency required
  • Verity CredentialStream experience preferred
  • Salesforce experience preferred
  • Athena EMR experience preferred
  • Demonstrated skills in problem solving and analysis and resolution
  • Advanced Microsoft Excel skills
  • Ability to function independently and possess flexibility in multiple project management
  • Ability to communicate effectively with practitioners, internal stakeholders, and providers
  • High level of attention to detail and exceptional organizational skills
  • Ability to exercise independent judgment in interpreting guidelines of applicable regulatory bodies
What We Offer

Privia Health offers a competitive salary range of $57,000 to $62,000 in base pay, with an annual bonus targeted at 10% based on performance. This role is also eligible for expense reimbursement to offset the cost of internet connection.

Privia Health is committed to creating a work environment that allows and encourages you to bring your whole self to work. We are an equal opportunity employer and welcome applications from diverse candidates.



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