Provider Enrollment Specialist II
Easterseals Southern California, Auburn Hills, MI, United States
Easterseals MORC is hiring for a
Provider Enrollment Specialist
to help make a difference and become part of something bigger than yourself!
We are looking for Game Changers !
The types of people who wake up excited to make a difference. The superheroes of their field who care about the people they serve. If that sounds like you, we want you on our team.
Benefits of Being a Superhero!
Benefits:
Low-cost Dental/Health/Vision insurance Dependent care reimbursement, and up to 5 days paid FMLA for maternity, paternity, foster care and adoption. Generous 401K retirement plan Paid Leave Options Available Up to $125 bonus for taking 5 days off in a row. 10 paid holidays and 3 floating holidays (Over 30 days total of paid time off) Wellness Programs We are a PSLF (Public Service Loan Forgiveness) Employer. We provide bonuses and extra incentives to reward hard work & dedication. Mileage reimbursement in accordance with IRS rate. Free financial planning services through our partnerships with the LoVasco Consulting Group, and SoFi. Student loan repayment options Pet Insurance Qualifications:
High School Diploma or equivilent Two years experience in clinic, business, or medical office preferred One year of Provider Enrollment exprience preferred Excellent organizational and project planning skills with the ability to work on several projects simultaneously, work well under pressure, and meet deadlines.
Duties and Responsibilities
Facilitate enrollment of new Easterseals MORC providers to ensure proper and timely billing and collections Prepare enrollment applications for all health plans including Medicare and Medicaid Complete data entry and processing of enrollment applications, with validation of provider submitted information to ensure the application is complete, accurate, and meeting Easterseals MORC standards Obtain licensure, certification and insurance certificates at time of enrollment and maintain in database in order to submit with enrollment applications Maintain timelines on enrollment processes, and address and/or escalate any delays Ensure that all pending enrollments are reviewed, obtained and managed according to the rules and policies of the department Provide monthly notification of new providers, resignations, and changes in provider status such as practice locations and panel status to contracted plans Follow up with necessary contacts, including providers and managed care organizations, to resolve enrollment application issues and deficiencies Facilitate resolution of provider related denials to ensure appeal procedures are followed to result in proper reimbursement Demonstrate a level of competence and understanding of all state and federal laws, rules and regulations according to payer guidelines for billing
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
Provider Enrollment Specialist
to help make a difference and become part of something bigger than yourself!
We are looking for Game Changers !
The types of people who wake up excited to make a difference. The superheroes of their field who care about the people they serve. If that sounds like you, we want you on our team.
Benefits of Being a Superhero!
Benefits:
Low-cost Dental/Health/Vision insurance Dependent care reimbursement, and up to 5 days paid FMLA for maternity, paternity, foster care and adoption. Generous 401K retirement plan Paid Leave Options Available Up to $125 bonus for taking 5 days off in a row. 10 paid holidays and 3 floating holidays (Over 30 days total of paid time off) Wellness Programs We are a PSLF (Public Service Loan Forgiveness) Employer. We provide bonuses and extra incentives to reward hard work & dedication. Mileage reimbursement in accordance with IRS rate. Free financial planning services through our partnerships with the LoVasco Consulting Group, and SoFi. Student loan repayment options Pet Insurance Qualifications:
High School Diploma or equivilent Two years experience in clinic, business, or medical office preferred One year of Provider Enrollment exprience preferred Excellent organizational and project planning skills with the ability to work on several projects simultaneously, work well under pressure, and meet deadlines.
Duties and Responsibilities
Facilitate enrollment of new Easterseals MORC providers to ensure proper and timely billing and collections Prepare enrollment applications for all health plans including Medicare and Medicaid Complete data entry and processing of enrollment applications, with validation of provider submitted information to ensure the application is complete, accurate, and meeting Easterseals MORC standards Obtain licensure, certification and insurance certificates at time of enrollment and maintain in database in order to submit with enrollment applications Maintain timelines on enrollment processes, and address and/or escalate any delays Ensure that all pending enrollments are reviewed, obtained and managed according to the rules and policies of the department Provide monthly notification of new providers, resignations, and changes in provider status such as practice locations and panel status to contracted plans Follow up with necessary contacts, including providers and managed care organizations, to resolve enrollment application issues and deficiencies Facilitate resolution of provider related denials to ensure appeal procedures are followed to result in proper reimbursement Demonstrate a level of competence and understanding of all state and federal laws, rules and regulations according to payer guidelines for billing
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.