Job Type
Full-time
Description
Pay Rate: Up to $28/hour based on experience
Schedule: Mon-Fri 8-5 CST
Location: Remote
This role is intended to improve enrollment turnaround, reduce dollars on hold, and provide consistent ownership of enrollment-related system work across all payers by supporting payer enrollment execution and revenue growth, with a primary focus on Athena enrollment dashboards, worklists, and payer setup tasks.
Provider Enrollment Specialist Job Duties:
- Manages the timely and accurate submission of provider enrollment applications for all insurance types, including enrollment and reassignment of Medicaid, Managed Medicaid, and commercial programs.
- Own and work the Athena enrollment-related tasks daily.
- Tracks and updates enrollment statuses on a real-time basis.
- Maintains the timelines for all enrollment schedules and provides updates to others as needed.
- Updates and maintains CAQH profiles to ensure data is accurate, attestations are current, and do not expire.
- Coordinates the receipt and processing of all credentialing data needed for enrollment, contracting, and other related purposes.
- Works closely with providers to obtain missing documentation for provider’s enrollment.
- Obtains required provider signatures and follows up with the carriers on documentation submitted.
- Responds to internal and external inquiries on enrollment and contract matters.
- Performs other duties as required or assigned within the scope of responsibility, including supporting other functions and teams within the Revenue Cycle.
Requirements
- Prior experience in payer or provider enrollment or enrollment operations (3 years minimum experience)
- Hands-on experience working in Athena (payer setup, enrollment dashboards, or worklists) required
- Salesforce experience preferred
- Medicaid and Medicaid Enrollment experience required
- Experience working with payer portals required
- Multi-payer and multi-state enrollment experience required
- Understanding of enrollment dependencies such as:
- Provider vs group enrollment
- EFT / ERA
- Pay-to setup
- Strong organizational skills and follow-through