Provider Enrollment Specialist

Provider Enrollment Specialist

Company Overview

ADOCS Dermatology Group is one of the largest and most established dermatology practices in the nation. With more than 200 providers within 80+ locations in 10 states, we have been serving patients for over 40 years. At DOCS, we strive to put the patient first with an emphasis on medical, surgical, and cosmetic dermatology. We provide easy access to high quality dermatologic care in an environment that is consistently friendly, convenient, courteous, and caring.

Summary

The Provider Enrollment Specialist is responsible for organizing, maintaining, and verifying all aspects of the enrollment process. This includes activities, such as application submission and follow up. The Provider Enrollment Specialist must also maintain a high level of accuracy and integrity while demonstrating problem-solving skills to ensure provider files are maintained.

Principle Duties and Responsibilities

• Obtain all required provider information required for payer enrollment.
• Maintain and update provider expirables (malpractice insurance, licenses, DEAs, board certification, etc.).
• Maintain a database for provider credentialing and update applicable software/systems as needed.
• Perform detailed analyses of application and primary source verification information.
• Identify discrepancies with credentialing documentation or history and notify the
• Provider Enrollment Manager of significant discrepancies.
• Enroll providers with payers by providing information to the payers as applicable. This includes all requirements for Medicare/Medicaid.
• Complete required documents and applications for credentialing, recredentialing, and privileging providers at assigned hospitals.
• Complete, update and maintain provider CAQH data.
• Provide exceptional customer service to providers, administration, executive staff, and external contacts.
• Support the enrollment department and corporate strategic plan by establishing long- term goals, short-term goals, and objectives.
• Demonstrate teamwork and collaboration.
• Perform other duties as assigned.

Minimum Qualifications

• Associate's degree from an accredited university or commensurate work experience (preferred).
• Minimum 2 years of provider enrollment experience (required).
• Proficient computer skills, particularly in Word and Excel.
• Credentialing Software knowledge (strongly preferred).
• Certification in medical staff services by the National Association of Medical Staff Services (NAMSS) or Certified Provider Credentialing Specialist (CPCS), preferred.

Benefits

• Our benefits package includes medical, dental, and vision insurance, 401k matching, company paid life insurance, employee assistance program, and paid time off.

Skills and Abilities

• Ability to present written and oral information in an accurate, clear, succinct, and understandable manner.
• Strong detail orientation.
• Decisiveness, organization, and proactivity.
• Ability to remain flexible and adapt to changing situations with minimal loss of efficiency.
• Ability to use inductive and deductive reasoning to formulate general rules or principles and apply them to tasks.
• Ability to collaborate with other members of the credentialing team to achieve departmental goals.

Physical Demands

Employees may be regularly required to sit, talk, hear, and use hands and fingers to operate a computer, telephone, and keyboard while performing the duties of this job.

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status