Provider Enrollment Specialist

EyeCare Partners is the nation’s leading provider of clinically integrated eye care. Our national network of over 300 ophthalmologists and 700 optometrists provides a lifetime of care to our patients with a mission to enhance vision, advance eye care and improve lives. Based in St. Louis, Missouri, over 650 ECP-affiliated practice locations provide care in 18 states and 80 markets, providing services that span the eye care continuum. For more information, visit www.eyecare-partners.com .

Job Title: Provider Enrollment Specialist

MUST LIVE IN ONE OF OUR 18 States: Missouri, Florida, Kansas, Kentucky, Pennsylvania, Virginia, New Jersey, Texas, Minnesota, Michigan, Oklahoma, Alabama, North Carolina, Georgia, Illinois, Ohio, Indiana, Arizona

Job Summary

Our growing eye care organization has an immediate need for an experienced Provider Enrollment Specialist who is familiar with provider data management and credentialing. A successful individual in this role will manage multiple enrollments and priorities while providing support to the Supervisor of Provider Enrollment.

Duties and Responsibilities

Enroll providers with payers by providing information to the payers as applicable. This includes Medicare, Medicaid, commercial plans, and MCOs.

Complete required documentation and applications for credentialing, recredentialing and privileging providers at assigned hospitals/ facilities.

Serve as the first point of contact for internal office and provider requests.

Maintain a database for provider credentialing and update the applicable software/ systems as needed to ensure all provider enrollment data is up-to-date and current.

Keep CAQH updated with accurate and current information.

Keep NPPES updated with accurate and current information.

Maintain constant contact with insurance payer representatives.

Communicate effectively any enrollment updates and issues to leadership.

Follow up with payers on outstanding enrollments on a weekly basis.

Maintain all demographic changes for all providers.

Maintain all hospital appointments and re-appointments.

Maintain and renew provider expirables (medical license, DEAs, board certification, malpractice insurance, etc.).

Education:

High School Diploma or GED Required

Experience Requirements

2+ years of related experience or training, equivalent combination of education and experience will be considered

Knowledge, Skills and Abilities Requirements

Professional in appearance and actions

Logical and Critical thinking skills for problem solving and analysis.

In-depth knowledge of performance metrics

Customer-focused with excellent written, listening and verbal communication skills

Ability to maintain control of a call de-escalating issues and instilling confidence that a resolution will be found

Ability to function effectively under stress of conflicting demands on time and attention, while successfully meeting deadlines

Enjoys learning new technologies and systems • Detail oriented, professional attitude, reliable

Exhibits a positive attitude and is flexible in accepting work assignments and priorities

Meets attendance and tardiness expectations, ability to work overtime, if required.

Management and organizational skills to support the leadership of this function

Ability to follow or provide verbal & written instructions with sufficient grammar and spelling skills to avoid mistakes or misinterpretations

Interpersonal skills to support customer service, functional, and teammate support need

Able to communicate effectively in English, both verbally and in writing

Ability for basic to intermediate problem solving, including mathematics

Intermediate computer operation

Proficiency with Microsoft Excel, Word, PowerPoint and Outlook

Specialty knowledge of systems relating to job function

Knowledge of state and federal regulations for this position; general understanding of HIPAA guidelines

Other Skills and Ability

Proficient computer skills, particularly in Microsoft

Good understanding of insurance payers and enrollment methods.

Ability to diagnose and resolve basic enrollment issues

Excellent organizational skills

Desire to gain industry knowledge and training

Demonstrates initiative in accomplishing goals

Ability to grow, adapt, and accept change

Consistently creating a positive work environment by being team-oriented

Excellent verbal, written, and social skills.

Ability to work overtime if/when needed

Location:

Work takes place in a remote work environment. Travel to other locations may be necessary to fulfill the essential duties and responsibilities of the job. Thus, those needing to travel for work must have access to dependable transportation, and their driving record must meet company liability carrier standards.

Please do not contact the office directly – only resumes submitted through this website will be considered.

If you need assistance with this application, please contact (636) 227-2600

EyeCare Partners is an equal opportunity/affirmative action employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.

Job descriptions are intended to be accurate reflections of those principal job elements essential for making fair pay decisions about jobs. Nothing in this job description restricts management right to assign or reassign duties and responsibilities to this job at any time.