Enrollment Specialist

Enrollment Specialist – Work from Home

This is a remote/ work from home position.

The Enrollment Specialist will perform functions of provider enrollment, including new hire enrollment, re-credentialing and ongoing maintenance of provider credentials.

Responsibilities:

• Create and facilitate completion of clinician applications for payers and facilities to ensure timely credentialing and enrollment
• Process credentialing and re-credentialing applications of providers
• Identify, obtain, verify and update database with providers’ credentialing information
• Review at least monthly, the disciplinary action reports issued by state licensing bodies and the OIG Medicaid and Medicare Sanctions report
• Update CAQH database
• Update contracted facilities with current credentials on clinicians
• Other tasks as assigned

Qualifications:

• High school diploma or GED, college degree preferred
• CPCS certified preferred or ability to obtain in 3 years
• 2+ years provider enrollment experience
• Must be familiar with insurance plans and enrollment process for Kentucky
• Professional and effective oral and written communication skills
• Organizational skills; ability to multi-task and manage priorities; meet critical deadlines
• Proficient in Microsoft Excel, Outlook and Word
• Experience with credentialing and CRM applications such as IntelliSoft, SalesForce, Microsoft Dynamics CRM