PROVIDER ENROLLMENT SPECIALIST II (WORK FROM HOME)

Company: Envision Healthcare
Location: Raleigh
Posted on: November 20, 2020

Job Description:

OVERVIEW

Envision Physician Services is a multispecialty physician group and practice management company. Established in 1953, our organization provides anesthesia, emergency medicine, hospital medicine, radiology, primary/urgent care, surgical services, and women s and children s health services to hospitals and health systems nationwide. Sheridan Healthcare, EmCare, Reimbursement Technologies and Emergency Medical Associates have recently joined forces to form Envision Physician Services. As one organization, we now provide a greater scope of service than any other national physician group. Our collective experience from hundreds of local, customized engagements, culture of continuous lean process improvement, and team of experts in the business of healthcare enable us to better solve complex problems and consistently give healthcare organizations confidence in our execution. Our combined organization serves more than 780 healthcare facilities in 48 states and the District of Columbia.



If you are looking for a stable, fast-paced, growing company in the healthcare industry that is committed to innovation, excellence and integrity, then this may be a great next step in the advancement of your career.



We currently have an exciting opportunity available for a Provider Enrollment Specialist Virtual.



The Representative Provider Enrollment Maintenance is responsible for proactively completing all provider enrollment maintenance activities. This position is responsible for minimizing any lapses in clinician and/or group enrollment and write off s/holds related to maintenance activities. This position is responsible for verifying maintenance requirements, ensuring centralized payer library is current and communicating updates to management and colleagues.

RESPONSIBILITIES

* Complete all maintenance activities including research, recording, communication & information sharing, submission, confirmation and follow up

* Maintenance activities include, but are not limited to:

* Medicare & Medicaid revalidations

* Recredentialing for all payers

* Creation and maintenance of CAQH practice and clinician profiles

* Submission of clinician updates e.g. licensure and certificates of insurance to payers

* Completion of any/all requests for data validation from payers and internal customers

* Manage roster submission, review and data entry

* Demographic and other reportable changes, including, but not limited to, terminations, change of ownership, and change of information

* Collaborate with colleagues to resolve enrollment related denials associated with maintenance

* Collaborate with Analyst and/or RCM to proactively monitor enrollment status for payers that require claim activity to remain participating

* Partner with Analyst to communicate any form updates required

* Partner with Manager to communicate any payer maintenance activity updates required

* Occasional overtime and/or participation on special projects may be required

* Other duties as assigned

QUALIFICATIONS

Education/Experience

* High school diploma or equivalent; some college preferred and 0-2 or years of related experience; or equivalent combination of education and experience

Computer Skills

To perform this job successfully, an individual should have knowledge of:

* Microsoft Office Suite

Envision Physician Services uses E-Verify to confirm the employment eligibility of all newly hired employees. To learn more about E-Verify, including your rights and responsibilities, please visit www.dhs.gov/E-Verify.

Envision Physician Services is an Equal Opportunity Employer.



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Keywords: Envision Healthcare, Raleigh , PROVIDER ENROLLMENT SPECIALIST II (WORK FROM HOME), Other , Raleigh, North Carolina