What are the responsibilities and job description for the Provider Enrollment/Credentialing Specialist position at Aviva Health?
WHO WE ARE:
Aviva Health is a dynamic and mission-driven federally qualified health center (FQHC). Committed to providing comprehensive and compassionate healthcare services, Aviva Health offers a holistic approach to care, addressing patients' medical, behavioral health, dental, and social service needs. As a vital healthcare resource in the community, Aviva Health fosters a collaborative and supportive work environment where dedicated healthcare professionals have the opportunity to make a meaningful impact on the lives of individuals and families. Join us at Aviva Health and be part of a team that is dedicated to making a difference in the lives of our patients and the community we serve.
BENEFITS INCLUDED:
- Monday - Friday Scheduling
- Paid Holidays
- PTO
- Comprehensive Medical, Dental, and Vision Coverage
- 403(b) Retirement with Employer Match
POSITION PURPOSE:
The Provider Enrollment/Credentialing Specialist is responsible for initiating and monitoring provider enrollment through the credentialing and recredentialing that is required for payer contracts. This position maintains logs of provider enrollment approvals, maintains a contact list for all payer contracts, and investigates any issues pertaining to provider enrollment with payers.
ESSENTIAL FUNCTIONS:
- Accurately and efficiently enrolls organization’s healthcare providers with contracted insurance plans on behalf of the organization.
- Maintains provider enrollment spreadsheet by tracking provider approvals and statuses for DMAP, Medicare and all insurance payers.
- Provides consistent and timely follow-up to insurance payers to maintain provider’s status in respective plans.
- Responds to all payer requests for additional/missing information through communication with
- Ensures all providers appear in payer directories with correct information, taxonomies and
- Performs primary source verifications according to organizational and accreditation
- Troubleshoots providers’ application status with all insurance
- Processes credentialing applications in accordance with federal, state and regulatory
- Collaborates with Credentialing Specialist to ensure all information is documented in providers’
- Assists the Credentialing Specialist with the internal credentialing process as
- Follows all Aviva Health policies, procedures, guidance, and
- Occasionally travels for conferences and training using company vehicles or personal
- Other duties as
QUALIFICATIONS:
- High school diploma or GED
- Minimum of two years of provider enrollment and credentialing experience
- Ability to multitask, work independently, be organized and self-
- Proficiency with the use of computers, the internet and Microsoft or other similar
- Excellent typing skills and attention to detail
- Excellent communication and interpersonal skills
- Minimum of two years of experience in a medical office setting
Aviva Health is an Equal Opportunity Employer
We are committed to fostering a diverse and inclusive workplace where all qualified applicants receive consideration for employment without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, age, disability, veteran status, or any other legally protected status.
Aviva Health is a Drug-Free Workplace
To ensure a safe and secure environment for our employees and patients, Aviva Health maintains a drug-free workplace. All employment offers are contingent upon passing a drug screening and a criminal background check. Compliance with these policies is required throughout employment.