• Job Description

  Req#: JR10965
  Melville,NY - USA

  Position Requirements

  The Provider Enrollment Specialist II will be responsible for the larger and /or overarching functions of the provider enrollment credentialing process they manage within team territories they are assigned such as larger payors, special tasks, Government payors or Provider Liaison services.

  Responsibilities:

  For Provider Enrollment Specialist II with larger payors, team tasks or Government payor responsibilities:

  • Complete and accurately submit provider enrollment applications, spreadsheets, and letters

  • Research & keep current on payer, hospital, ASC & office-based guidelines as needed to ensure processes are accurate.

  • Review and create workflows to identify accuracy, efficiency, and best practices.

  • Assist provider enrollment credentialing staff in their zone/region, monitor workflows, and provide support and training as required

  • Follow up with payors to ensure timely enrollment, re-enrollment, and participation

  • Review and follow up on weekly billing reports

  • Data entry of all provider information into the Credentialing Database

  • Handle incoming requests from physicians, payors, and other agencies

  • Verify integrity of data

  • Oversee the completion of online provider CAQH re-attestations

  • Assist with the development and maintenance of departmental policies and procedures

  • Assist/lead new business implementations

  • Assist in internal departments by resolving payment and denial issues as it relates to credentialing

  • Travel between hospitals and other clinical work locations to meet with providers to obtain signatures on required documents as needed

  • Facilitate and attend meetings and seminars as required

  • Produce weekly and monthly productivity and issues report for management

  • Other responsibilities as assigned

  For Provider Enrollment Specialist II that manage Provider Services liaison responsibilities for the team:

  • Be able to initiate and act as liaison between providers and all Specialists within their territory/group with professionalism, respect and within time frames to maximize efficiencies

  • Assist credentialing staff in their zone/region, monitor workflows, and provide support and training as required

  • As region/zone Provider Services point person, assist, and interact with Regional Clinical and Operational leadership by assisting with resolving any provider enrollment issues, questions or concerns and/ or expedite processes for enrollment processes

  • Travel between hospitals and other clinical work locations to meet with providers to obtain signatures on required documents as needed

  • Facilitate and attend meetings and seminars as required

  • Produce weekly and monthly productivity and issues report for management

  • Other responsibilities as assigned

  Qualification/Requirement:

  • Positive and professional attitude

  • Ability to work with all levels of associates from entry level to upper-level management

  • Ability to work independently or in a group setting

  • Previous credentialing or enrollment experience a plus

  • Strong knowledge of provider enrollment credentialing in a physician office, managed care or hospital setting

  • Must be a self-starter and a team player who enjoys providing the highest level of customer service.

  • Experience working with databases, and ability to create and manipulate excel spreadsheets

  • Ability to multi-task and prioritize in a fast-paced environment

  • Strong communication and follow up skills

  • Professional business sense and leadership skills

  • Strong experience with Microsoft Office (Excel & Word specifically)

  • Local & distance travel may be required.

  Education and/or Experience

  • Associates Degree, Bachelor’s Degree, and/or equivalent work experience. A minimum of three years provider enrollment/credentialing experience.

  Total Rewards

  • Salary: $19.39-$26.66 hourly

  • Generous benefits package, including:

  • Paid Time Off

  • Health, life, vision, dental, disability, and AD&D insurance

  • Flexible Spending Accounts/Health Savings Accounts

  • 401(k)

  • Leadership and professional development opportunities

  EEO Statement

  North American Partners in Anesthesia is an equal opportunity employer.

• About the company

  Founded in 1986, North American Partners in Anesthesia (NAPA) is the leading single specialty anesthesia and perioperative management company in the USA.

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